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Organization
THE HERITAGE SHADYSIDE
Active
Organization
THE HERITAGE SHADYSIDE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM ANTHONY NIGRO CPA (CHIEF FINANCIAL OFFICER)
(412) 864-3532
Entity
Organization
Contact information
Practice address
5701 PHILLIPS AVE, PITTSBURGH, PA 15217-2254
(412) 422-5100
(412) 422-6208
Mailing address
200 LOTHROP ST STE 10097, PITTSBURGH, PA 15213-2536
(412) 864-3532
(412) 864-3554
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
086102
PA
314000000X
Skilled Nursing Facility
Primary
086102
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0019010200001
—
PA
01
—
0477
HIGHMARK BLUE CROSS
—
01
—
V6004A
UPMC HEALTH PLAN
—
Enumeration date
09/12/2006
Last updated
09/10/2020
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