Provider Demographics
NPI:1265440093
Name:UPMC SOUTH SIDE
Entity type:Organization
Organization Name:UPMC SOUTH SIDE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:CFO
Authorized Official - Phone:412-488-5573
Mailing Address - Street 1:PO BOX 382007
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15250-8007
Mailing Address - Country:US
Mailing Address - Phone:412-432-5500
Mailing Address - Fax:
Practice Address - Street 1:2000 MARY ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15203-2054
Practice Address - Country:US
Practice Address - Phone:412-432-5500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0006491155OtherAETNA US HEALTHCARE NUMBE
PA1007727710002OtherION HEALTHCARE NUMBER
PA27178278000OtherSTATE WVA WC NUMBER
PA38OtherUPMC HEALTH PLAN NUMBER
PA38OtherUPMC FOR YOU NUMBER
PA1007727710002Medicaid
PA0016OtherHIGHMARK PROVIDER NUMBER
PA390131OtherHEALTHAMERICA NUMBER
PA46735OtherGATEWAY NUMBER
PA000000060360OtherMEDPLUS NUMBER
PA0013199OtherAETNA HMO NUMBER
PA0013199OtherAETNA HMO NUMBER
PA1007727710002OtherION HEALTHCARE NUMBER