Provider Demographics
NPI:1982608832
Name:ADVANCED II
Entity Type:Organization
Organization Name:ADVANCED II
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-344-4100
Mailing Address - Street 1:3912 LIBRARY RD
Mailing Address - Street 2:STE 202
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15234-1844
Mailing Address - Country:US
Mailing Address - Phone:412-344-4100
Mailing Address - Fax:412-344-4104
Practice Address - Street 1:290 BILMAR DR STE 301
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15205-4601
Practice Address - Country:US
Practice Address - Phone:412-344-4100
Practice Address - Fax:412-344-4104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-09
Last Update Date:2019-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA77590501251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA397759Medicare ID - Type Unspecified