Provider Demographics
NPI:1952420325
Name:THE WESTERN PENNSYLVANIA HOSPITAL
Entity Type:Organization
Organization Name:THE WESTERN PENNSYLVANIA HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:JIM
Authorized Official - Middle Name:
Authorized Official - Last Name:KANUCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:4412-578-6907
Mailing Address - Street 1:4800 FRIENDSHIP AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15224-1722
Mailing Address - Country:US
Mailing Address - Phone:412-578-5000
Mailing Address - Fax:412-578-1296
Practice Address - Street 1:4800 FRIENDSHIP AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15224-1722
Practice Address - Country:US
Practice Address - Phone:412-578-5000
Practice Address - Fax:412-578-1296
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE WESTERN PENNSYLVANIA HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-28
Last Update Date:2012-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA234401261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007277200050Medicaid
PA1007277200050Medicaid