Provider Demographics
NPI:1306138169
Name:UPMC/ST CLAIR HOSPITAL CANCER CENTER
Entity type:Organization
Organization Name:UPMC/ST CLAIR HOSPITAL CANCER CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:E
Authorized Official - Last Name:BOGOSTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-692-2451
Mailing Address - Street 1:2 HOT METAL ST FL 3
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15203-2348
Mailing Address - Country:US
Mailing Address - Phone:412-432-7469
Mailing Address - Fax:412-647-4486
Practice Address - Street 1:1020 BOWER HILL RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15243-1843
Practice Address - Country:US
Practice Address - Phone:412-502-3920
Practice Address - Fax:412-502-3933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-11
Last Update Date:2018-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty