PYRAMID HEALTHCARE INC. NPI 1063533040

NPI Information

NPI: 1063533040
Provider Name: PYRAMID HEALTHCARE INC.
Classification: Clinic/Center - 261QR0405X
Entity Type: Organization

Specialization: Rehabilitation, Substance Use Disorder

CLIA Number: 39D2241601

Address:
2409 STATE ST
ERIE, PA
ZIP 16503
Phone: (814) 456-2203
Get Directions

PYRAMID HEALTHCARE INC. is a rehabilitation and substance use disorder clinic center in Erie, PA. PYRAMID HEALTHCARE INC. NPI is 1063533040. The provider is registered as an organization entity type.

The provider's business location address is:

2409 STATE ST
ERIE, PA
ZIP 16503-856
Phone: (814) 456-2203
Fax: (814) 456-2205

The provider's authorized official is Jason Hendricks .
The authorized official title is Ceo and has the following contact phone number (814) 940-0407.

The CLIA number assigned to this NPI record is 39D2241601 - other - drug & alcohol outpatient with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/3/2007 and was last updated on 3/18/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder	257077	PENNSYLVANIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1007625050097	MEDICAID	PENNSYLVANIA
2	1007625050094	MEDICAID	PENNSYLVANIA
3	1007625050096	MEDICAID	PENNSYLVANIA
4	257077	OTHER	PENNSYLVANIA	LICENSE NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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