Basic Information
| Provider Information | |||||||||
| NPI: | 1821110172 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | WEST PENN ALLEGHENY HEALTH SYSTEM INC. | ||||||||
| LastName: | |||||||||
| FirstName: | |||||||||
| MiddleName: | |||||||||
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| Credential: | |||||||||
| OtherOrganizationName: | ALLEGHENY GENERAL HOSPITAL - LIFE FLIGHT | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 5TH AVE FL 14 | ||||||||
| Address2: | |||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152223133 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4123306062 | ||||||||
| FaxNumber: | 4123306040 | ||||||||
| Practice Location | |||||||||
| Address1: | 320 EAST NORTH AVENUE | ||||||||
| Address2: | |||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152124756 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4123593131 | ||||||||
| FaxNumber: | 4123594108 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/06/2007 | ||||||||
| LastUpdateDate: | 01/16/2019 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | JAFFEE | ||||||||
| AuthorizedOfficialFirstName: | DON | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | CFO - ALLEGHENY GENERAL HOSPITAL | ||||||||
| AuthorizedOfficialTelephone: | 4123593935 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | WEST PENN ALLEGHENY HEALTH SYSTEM INC. | ||||||||
| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 3416L0300X | N | Transportation Services | Ambulance | Land Transport | 3416A0800X | 530101 | PA | Y | Transportation Services | Ambulance | Air Transport |
No ID Information.