Provider Demographics
NPI:1457339970
Name:LIFE HOME CARE LP
Entity Type:Organization
Organization Name:LIFE HOME CARE LP
Other - Org Name:UPMC HOME MEDICAL EQUIPMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-773-6904
Mailing Address - Street 1:250 TECHNOLOGY DR
Mailing Address - Street 2:ATTN: UPMC HOME MEDICAL EQUIPMENT
Mailing Address - City:CANONSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15317-9564
Mailing Address - Country:US
Mailing Address - Phone:724-873-7844
Mailing Address - Fax:949-639-6368
Practice Address - Street 1:2310 JANE ST
Practice Address - Street 2:SUITE 1300
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15203-2362
Practice Address - Country:US
Practice Address - Phone:800-247-6333
Practice Address - Fax:412-235-1335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-04
Last Update Date:2012-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
209290OtherUPMC HEALTH PLAN
PA1007759150075Medicaid
PA1007759150075Medicaid