Basic Information
| Provider Information | |||||||||
| NPI: | 1659443158 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | UPMC HOME HEALTHCARE OF CENTRAL PENNSYLVANIA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 201 CHESTNUT AVE | ||||||||
| Address2: | HOME HEALTH | ||||||||
| City: | ALTOONA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 166014927 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8149465411 | ||||||||
| FaxNumber: | 8149421673 | ||||||||
| Practice Location | |||||||||
| Address1: | 20 SHERATON DR | ||||||||
| Address2: | HOME HEALTH | ||||||||
| City: | ALTOONA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 166019316 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8149411384 | ||||||||
| FaxNumber: | 8149411627 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/14/2006 | ||||||||
| LastUpdateDate: | 03/16/2021 | ||||||||
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| AuthorizedOfficialLastName: | THOMAS | ||||||||
| AuthorizedOfficialFirstName: | PAULA | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8149465411 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 03/16/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251E00000X | 708705 | PA | Y | Agencies | Home Health |
ID Information
| ID | Type | State | Issuer | Description | 1007767800014 | 05 | PA | MEDICAID | 0739 | 01 | PA | HIGHMARK | OTHER | 1020805 | 01 | PA | ACM | OTHER | 300187 | 01 | PA | UPMC FOR YOU - BEST | OTHER | 58159 | 01 | PA | GEISINGER | OTHER | 1007767800063 | 05 | PA | MEDICAID | 1018267 | 01 | PA | GATEWAY | OTHER | 1736 | 01 | PA | BLUE SHIELD | OTHER |