Provider Demographics
NPI:1316757040
Name:OSPTA HOME, LLC
Entity type:Organization
Organization Name:OSPTA HOME, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:POPELAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-565-5804
Mailing Address - Street 1:4325 STATE ROUTE 51
Mailing Address - Street 2:
Mailing Address - City:ROSTRAVER TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:15012-3535
Mailing Address - Country:US
Mailing Address - Phone:724-483-4859
Mailing Address - Fax:724-798-8367
Practice Address - Street 1:4325 STATE ROUTE 51
Practice Address - Street 2:
Practice Address - City:ROSTRAVER TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:15012-3535
Practice Address - Country:US
Practice Address - Phone:724-483-4859
Practice Address - Fax:724-798-8367
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OSPTA HOME, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-01-14
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Single Specialty