Provider Demographics
NPI:1396724217
Name:UPMC ALTOONA REGIONAL HEALTH SERVICES, INC
Entity type:Organization
Organization Name:UPMC ALTOONA REGIONAL HEALTH SERVICES, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:M
Authorized Official - Last Name:SWAB
Authorized Official - Suffix:
Authorized Official - Credentials:CPCS
Authorized Official - Phone:814-949-7622
Mailing Address - Street 1:1414 9TH AVE
Mailing Address - Street 2:STATION MEDICAL CENTER
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16602-2454
Mailing Address - Country:US
Mailing Address - Phone:814-946-1655
Mailing Address - Fax:814-949-7616
Practice Address - Street 1:1414 9TH AVE
Practice Address - Street 2:STATION MEDICAL CENTER
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16602-2454
Practice Address - Country:US
Practice Address - Phone:814-946-1655
Practice Address - Fax:814-949-7616
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-10
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1019546OtherGATEWAY PEDS
PA1015340OtherGATEWAY IM
PA142869OtherHIGHMARK PCP NUMBER
PA1015349OtherGATEWAY FP
PAW463OtherGEISINGER OFFICE NO.
PA142869Medicare ID - Type UnspecifiedPCP GROUP NUMBER