Provider Demographics
NPI:1336783323
Name:COMMONWEALTH HOSPICE LLC
Entity type:Organization
Organization Name:COMMONWEALTH HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:VAGLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-889-8741
Mailing Address - Street 1:4955 STEUBENVILLE PIKE STE 125
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15205-9699
Mailing Address - Country:US
Mailing Address - Phone:412-489-5893
Mailing Address - Fax:412-489-5891
Practice Address - Street 1:4955 STEUBENVILLE PIKE STE 125
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15205-9699
Practice Address - Country:US
Practice Address - Phone:412-489-5893
Practice Address - Fax:412-489-5891
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-01
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based