Provider Demographics
NPI:1770064008
Name:PRESSLEY RIDGE
Entity type:Organization
Organization Name:PRESSLEY RIDGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SUPERVISOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORA
Authorized Official - Middle Name:
Authorized Official - Last Name:KOST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-872-9422
Mailing Address - Street 1:1008 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:BEAVER FALLS
Mailing Address - State:PA
Mailing Address - Zip Code:15010-4530
Mailing Address - Country:US
Mailing Address - Phone:724-843-5320
Mailing Address - Fax:724-842-5401
Practice Address - Street 1:1008 7TH AVE
Practice Address - Street 2:
Practice Address - City:BEAVER FALLS
Practice Address - State:PA
Practice Address - Zip Code:15010-4530
Practice Address - Country:US
Practice Address - Phone:724-843-5320
Practice Address - Fax:724-842-5401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-24
Last Update Date:2018-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100003088Medicaid