Provider Demographics
NPI:1023299146
Name:UPMC KANE
Entity type:Organization
Organization Name:UPMC KANE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:GARY
Authorized Official - Last Name:RHODES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-837-8585
Mailing Address - Street 1:4372 ROUTE 6
Mailing Address - Street 2:
Mailing Address - City:KANE
Mailing Address - State:PA
Mailing Address - Zip Code:16735-3060
Mailing Address - Country:US
Mailing Address - Phone:814-837-8585
Mailing Address - Fax:814-837-4348
Practice Address - Street 1:628 N FRALEY ST
Practice Address - Street 2:SUITE 3
Practice Address - City:KANE
Practice Address - State:PA
Practice Address - Zip Code:16735-9040
Practice Address - Country:US
Practice Address - Phone:814-837-5171
Practice Address - Fax:814-837-7432
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UPMC HAMOT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-11-16
Last Update Date:2017-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA763105251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007457740051Medicaid
PA1057OtherHIGHMARK HHC
PA397631Medicare Oscar/Certification