Provider Demographics
NPI:1801350640
Name:SUNCREST HOSPICE PITTSBURGH, LLC
Entity type:Organization
Organization Name:SUNCREST HOSPICE PITTSBURGH, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:TYLER
Authorized Official - Middle Name:
Authorized Official - Last Name:GODFREY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-849-0486
Mailing Address - Street 1:9800 S MONROE ST STE 809
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84070-4419
Mailing Address - Country:US
Mailing Address - Phone:801-849-0486
Mailing Address - Fax:801-849-0476
Practice Address - Street 1:300 PENN CENTER BLVD STE 120
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15235-5501
Practice Address - Country:US
Practice Address - Phone:878-302-1136
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-25
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based