Provider Demographics
| NPI: | 1538253893 |
|---|---|
| Name: | ADAGIO HEALTH INC. |
| Entity type: | Organization |
| Organization Name: | ADAGIO HEALTH INC. |
| Other - Org Name: | <UNAVAIL> |
| Other - Org Type: | |
| Authorized Official - Title/Position: | CHIEF OPERATING OFFICER |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | DEBORA |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | WOOD |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 412-288-2130 |
| Mailing Address - Street 1: | 960 PENN AVE |
| Mailing Address - Street 2: | SUITE 600 |
| Mailing Address - City: | PITTSBURGH |
| Mailing Address - State: | PA |
| Mailing Address - Zip Code: | 15222-3818 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 412-288-2130 |
| Mailing Address - Fax: | 412-288-9036 |
| Practice Address - Street 1: | 211 N WHITFIELD ST |
| Practice Address - Street 2: | SUITE 850 |
| Practice Address - City: | PITTSBURGH |
| Practice Address - State: | PA |
| Practice Address - Zip Code: | 15206-3039 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 412-661-2900 |
| Practice Address - Fax: | 412-661-4905 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | Yes |
| Parent Organization LBN: | ADAGIO HEALTH INC. |
| Parent Organization TIN: | <UNAVAIL> |
| Enumeration Date: | 2006-10-03 |
| Last Update Date: | 2008-03-25 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 261QF0050X | Ambulatory Health Care Facilities | Clinic/Center | Family Planning, Non-Surgical | Group - Multi-Specialty |
| No | 101YA0400X | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | Group - Multi-Specialty |
| No | 133N00000X | Dietary & Nutritional Service Providers | Nutritionist | Group - Multi-Specialty | |
| No | 133NN1002X | Dietary & Nutritional Service Providers | Nutritionist | Nutrition, Education | Group - Multi-Specialty |
| No | 133V00000X | Dietary & Nutritional Service Providers | Dietitian, Registered | Group - Multi-Specialty | |
| No | 207V00000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Group - Multi-Specialty | |
| No | 207VG0400X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Gynecology | Group - Multi-Specialty |
| No | 207VX0000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Obstetrics | Group - Multi-Specialty |
| No | 261Q00000X | Ambulatory Health Care Facilities | Clinic/Center | ||
| No | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Group - Multi-Specialty | |
| No | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | Group - Multi-Specialty |
| No | 363LW0102X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Women's Health | Group - Multi-Specialty |
| No | 363LX0001X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Obstetrics & Gynecology | Group - Multi-Specialty |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| PA | 1042627 | Other | UPMC FOR YOU |
| PA | 1991407 | Other | HIGHMARK (CRNP) |
| PA | 064837 | Other | HIGHMARK (CRNP) |
| PA | 1007284320071 | Medicaid | |
| PA | 1011336 | Other | GATEWAY |
| PA | 1991406 | Other | HIGHMARK (PHYSICIAN) |
| PA | 882590 | Other | HIGHMARK (PHYSICIAN) |
| PA | 172743 | Other | UNISON |
| PA | AD1830898 | Other | HIGHMARK (DIETITIAN) |
| PA | E255 | Other | UPMC |
| PA | E255 | Other | UPMC |
