Provider Demographics
NPI:1730158981
Name:UPMC HANOVER
Entity type:Organization
Organization Name:UPMC HANOVER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP, FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:MULLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-316-2153
Mailing Address - Street 1:300 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-2297
Mailing Address - Country:US
Mailing Address - Phone:717-316-3711
Mailing Address - Fax:717-633-2217
Practice Address - Street 1:300 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-2297
Practice Address - Country:US
Practice Address - Phone:717-637-3711
Practice Address - Fax:717-633-2217
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-17
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
282N00000X
PA081801282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007440330006Medicaid
000000056697OtherUNISON (SPU)
PA1007440330018Medicaid
1015767OtherGATEWAY HEALTH PLAN
589944-01OtherMARYLAND BLUE CROSS
60770OtherAMERIHEALTH MERCY
PA1007440330024Medicaid
1552OtherHIGHMARK
6490485OtherAETNA INSURANCE
PA1007440330007Medicaid
000000082456OtherUNISON (IN & OUTPATIENT)
PA1007440330007Medicaid