Provider Demographics
NPI:1912094673
Name:INTERIM HEALTHCARE OF PITTSBURGH, INC.
Entity Type:Organization
Organization Name:INTERIM HEALTHCARE OF PITTSBURGH, INC.
Other - Org Name:INTERIM HEALTHCARE OF JOHNSTOWN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:DIMARCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-436-9404
Mailing Address - Street 1:322 WARREN STREET
Mailing Address - Street 2:SUITE 220
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15905-3443
Mailing Address - Country:US
Mailing Address - Phone:814-254-1230
Mailing Address - Fax:814-254-1236
Practice Address - Street 1:322 WARREN STREET
Practice Address - Street 2:SUITE 220
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15905-3443
Practice Address - Country:US
Practice Address - Phone:814-254-1230
Practice Address - Fax:814-254-1236
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INTERIM HEALTHCARE OF PITTSBURGH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-06
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA73110501251E00000X
253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1000059300009Medicaid
PA1000059300009Medicaid