Provider Demographics
NPI:1194734798
Name:UPMC MCKEESPORT
Entity type:Organization
Organization Name:UPMC MCKEESPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURENE
Authorized Official - Middle Name:
Authorized Official - Last Name:TIMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-664-6781
Mailing Address - Street 1:PO BOX 382007
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15250-8007
Mailing Address - Country:US
Mailing Address - Phone:412-432-5500
Mailing Address - Fax:
Practice Address - Street 1:1500 5TH AVE
Practice Address - Street 2:
Practice Address - City:MCKEESPORT
Practice Address - State:PA
Practice Address - Zip Code:15132-2422
Practice Address - Country:US
Practice Address - Phone:412-432-5500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA707299276400000X
282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No276400000XHospital UnitsRehabilitation, Substance Use Disorder Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0006490690OtherVALUE OPTIONS NUMBER
PA390002OtherHEALTHAMERICA NUMBER
PA0004839OtherUMWVA NUMBER
PA1000021OtherGATEWAY NUMBER
PA46OtherUPMC HEALTH PLAN NUMBER
PA0080001OtherAETNA US HEALTHCARE NUMBE
PA030796100OtherSTATE WV OH WC NUMBER
PA000000060306OtherMEDPLUS NUMBER
PA0008OtherHIGHMARK PROVIDER NUMBER
PA1007643400014OtherION HEALTHCARE NUMBER
NJ4196007Medicaid
NY01073330Medicaid
OH5784263Medicaid
PA0004847OtherUMWVA NUMBER
WV0101249Medicaid
PA10076434000014Medicaid
PA46OtherUPMC HEALTH PLAN NUMBER
PA1000021OtherGATEWAY NUMBER