Provider Demographics
NPI:1679902910
Name:UPMC COMPLETE CARE INC
Entity type:Organization
Organization Name:UPMC COMPLETE CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR.DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:EHALT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-647-0943
Mailing Address - Street 1:5215 CENTRE AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15232-1303
Mailing Address - Country:US
Mailing Address - Phone:412-623-6200
Mailing Address - Fax:412-623-6023
Practice Address - Street 1:5215 CENTRE AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15232-1303
Practice Address - Country:US
Practice Address - Phone:412-623-6200
Practice Address - Fax:412-623-6023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-07
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA042490Medicare PIN