Provider Demographics
NPI:1417076050
Name:PRESSLEY RIDGE
Entity type:Organization
Organization Name:PRESSLEY RIDGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR ACCOUNTING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BETH
Authorized Official - Middle Name:
Authorized Official - Last Name:BLAIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-321-6995
Mailing Address - Street 1:530 MARSHALL AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15214-3016
Mailing Address - Country:US
Mailing Address - Phone:412-321-6995
Mailing Address - Fax:412-321-7008
Practice Address - Street 1:530 MARSHALL AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15214-3098
Practice Address - Country:US
Practice Address - Phone:412-321-6995
Practice Address - Fax:412-321-7008
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRESSLEY RIDGE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-28
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1000030880039Medicaid