Provider Demographics
NPI:1487604179
Name:UPMC ALTOONA
Entity type:Organization
Organization Name:UPMC ALTOONA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:MURRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-889-2223
Mailing Address - Street 1:501 HOWARD AVE
Mailing Address - Street 2:SUITE F2
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16601-4810
Mailing Address - Country:US
Mailing Address - Phone:814-889-2701
Mailing Address - Fax:814-889-7864
Practice Address - Street 1:501 HOWARD AVE
Practice Address - Street 2:SUITE F2
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16601-4810
Practice Address - Country:US
Practice Address - Phone:814-889-2701
Practice Address - Fax:814-889-7864
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UPMC ALTOONA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-11
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA012801282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1014433OtherGATEWAY HEALTH PLAN
PAV0P017OtherUPMC HEALTH PLAN
PA14111OtherUPMC FOR YOU HEALTH PLAN
PA155623OtherHIGHMARK BC/BS
321200OtherFEDERAL BLACK LUNG
PA111333OtherUNISON HEALTH PLAN
PA1007278290086Medicaid
GACA9269OtherRAILROAD MEDICARE
PA111354OtherUNISON HEALTH PLAN OB
PAW402OtherGEISINGER HEALTH PLAN
PAW402OtherGEISINGER HEALTH PLAN
PA111354OtherUNISON HEALTH PLAN OB