Provider Demographics
NPI:1699387779
Name:ALLE KISKI MEDICAL CENTER
Entity type:Organization
Organization Name:ALLE KISKI MEDICAL CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR REIMBURSEMENT
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:TISCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-330-6062
Mailing Address - Street 1:1301 CARLISLE ST THIRD FLOOR
Mailing Address - Street 2:
Mailing Address - City:NATRONA HEIGHTS
Mailing Address - State:PA
Mailing Address - Zip Code:15065-1152
Mailing Address - Country:US
Mailing Address - Phone:724-226-7197
Mailing Address - Fax:724-389-6517
Practice Address - Street 1:1301 CARLISLE ST THIRD FLOOR
Practice Address - Street 2:
Practice Address - City:NATRONA HEIGHTS
Practice Address - State:PA
Practice Address - Zip Code:15065-1152
Practice Address - Country:US
Practice Address - Phone:724-226-7197
Practice Address - Fax:724-389-6517
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALLE-KISKI MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-08-19
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336I0012XSuppliersPharmacyInstitutional Pharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007447680011Medicaid