Provider Demographics
NPI: | 1699869826 |
---|---|
Name: | ADAGIO HEALTH INC. |
Entity type: | Organization |
Organization Name: | ADAGIO HEALTH INC. |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | CHIEF OPERATING OFFICER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | DEBORA |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | WOOD |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 412-288-2130 |
Mailing Address - Street 1: | 960 PENN AVE |
Mailing Address - Street 2: | SUITE 600 |
Mailing Address - City: | PITTSBURGH |
Mailing Address - State: | PA |
Mailing Address - Zip Code: | 15222-3818 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 412-288-2130 |
Mailing Address - Fax: | 412-288-9036 |
Practice Address - Street 1: | 607 CHARTIERS AVE |
Practice Address - Street 2: | |
Practice Address - City: | MC KEES ROCKS |
Practice Address - State: | PA |
Practice Address - Zip Code: | 15136-3814 |
Practice Address - Country: | US |
Practice Address - Phone: | 412-771-8794 |
Practice Address - Fax: | 412-771-8796 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | Yes |
Parent Organization LBN: | ADAGIO HEALTH INC. |
Parent Organization TIN: | <UNAVAIL> |
Enumeration Date: | 2006-10-03 |
Last Update Date: | 2007-08-02 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 261QF0050X | Ambulatory Health Care Facilities | Clinic/Center | Family Planning, Non-Surgical | Group - Multi-Specialty |
No | 101YA0400X | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | Group - Multi-Specialty |
No | 133N00000X | Dietary & Nutritional Service Providers | Nutritionist | Group - Multi-Specialty | |
No | 133NN1002X | Dietary & Nutritional Service Providers | Nutritionist | Nutrition, Education | Group - Multi-Specialty |
No | 133V00000X | Dietary & Nutritional Service Providers | Dietitian, Registered | Group - Multi-Specialty | |
No | 207V00000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Group - Multi-Specialty | |
No | 207VG0400X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Gynecology | Group - Multi-Specialty |
No | 207VX0000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Obstetrics | Group - Multi-Specialty |
No | 261Q00000X | Ambulatory Health Care Facilities | Clinic/Center | ||
No | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Group - Multi-Specialty | |
No | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | Group - Multi-Specialty |
No | 363LW0102X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Women's Health | Group - Multi-Specialty |
No | 363LX0001X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Obstetrics & Gynecology | Group - Multi-Specialty |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
PA | AD1830989 | Other | HIGHMARK (DIETITIAN) |
PA | 1044581 | Other | UMPC FOR YOU |
PA | 1007284320081 | Medicaid | |
PA | E275 | Other | UPMC |
PA | 1519266 | Other | GATEWAY |
PA | 171663 | Other | UNISON |
PA | 1007284320081 | Medicaid |