Provider Demographics
NPI:1134614621
Name:UPMC HOME HEALTHCARE OF CENTRAL PENNSYLVANIA
Entity type:Organization
Organization Name:UPMC HOME HEALTHCARE OF CENTRAL PENNSYLVANIA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIFFITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-778-4606
Mailing Address - Street 1:1100 GRAMPIAN BOULEVARD
Mailing Address - Street 2:FOUR SOUTH
Mailing Address - City:WILLIAMSPORT
Mailing Address - State:PA
Mailing Address - Zip Code:17701-1909
Mailing Address - Country:US
Mailing Address - Phone:570-320-7690
Mailing Address - Fax:570-323-0716
Practice Address - Street 1:1100 GRAMPIAN BOULEVARD
Practice Address - Street 2:FOUR SOUTH
Practice Address - City:WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17701
Practice Address - Country:US
Practice Address - Phone:570-320-7690
Practice Address - Fax:570-323-0716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-27
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA151399251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007767800070Medicaid