- Enrollment id
- O20090610000171
- Enrollment state
- PA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1790923019
- Multiple npi flag
- N
- Ccn
- 391718
- Associate id
- 5092865204
- Organization name
- INTERIM HEALTHCARE HOSPICE OF WESTERN PENNSYLVANIA, INC.
- Doing business as name
- INTERIM HEALTHCARE HOSPICE OF PITTSBURGH
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 285 KAPPA DR
- Address line 2
- STE 270
- City
- PITTSBURGH
- State
- PA
- Zip code
- 152382834