NPIMap

Organization Active NPI

Pyramid Healthcare Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Tyrone, PA
National Provider Identifier
1033230461
Registry record updated Apr 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
077026 Issued in PA
Legal business name
PYRAMID HEALTHCARE INC.
Practice address
13505 South Eagle Valley Road
Tyrone, PA 16686-8380
Phone
(814) 940-0407
Fax
(814) 941-0574
NPI assigned
Apr 3, 2007
Last updated
Apr 10, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Jason Hendricks
Title
Ceo
Phone
(814) 940-0407

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 077026 PA Primary

Addresses

Primary practice location

13505 South Eagle Valley Road
Tyrone, PA 16686-8380

Mailing address

P.O. Box 967
1894 Plank Road
Duncansville, PA 16635-8304
Phone (814) 940-0407

Other identifiers 1

IdentifierTypeStateIssuer
1007625050064MedicaidPA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D2243421Pyramid Healthcare Pine Ridge Manor HWH13505 South Eagle Valley Road, Tyrone, PA 16686Certificate of waiverNov 17, 2027

National Provider Directory

National Provider Directory
Tax ID family
Pyramid Healthcare40 organizations share this tax ID, including this one

Other organizations with this tax ID 39

Organizations that report the same tax identification number in the National Provider Directory.

View all 39

Locations

13505 S Eagle Valley Rd
Tyrone, PA 16686

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712707200000",
    "number": "1033230461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 967",
            "address_2": "1894 PLANK ROAD",
            "city": "DUNCANSVILLE",
            "state": "PA",
            "postal_code": "166358304",
            "telephone_number": "814-940-0407",
            "fax_number": "814-941-0574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13505 SOUTH EAGLE VALLEY ROAD",
            "city": "TYRONE",
            "state": "PA",
            "postal_code": "166868380",
            "telephone_number": "814-940-0407",
            "fax_number": "814-941-0574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PYRAMID HEALTHCARE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A",
        "authorized_official_last_name": "HENDRICKS",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "814-940-0407",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "PA",
            "license": "077026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007625050064",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyrone, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.