1437133576 NPI number — HEALTHCARE PARTNERS, LLC

Table of content: (NPI 1437133576)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437133576 NPI number — HEALTHCARE PARTNERS, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEALTHCARE PARTNERS, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
PROMEDICAL EAST LLC
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1437133576
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/14/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1429 COUNTY LINE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRYN MAWR
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19010-1604
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-525-3162
Provider Business Mailing Address Fax Number:
610-525-4009

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1429 COUNTY LINE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BRYN MAWR
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19010-1604
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-525-3162
Provider Business Practice Location Address Fax Number:
610-525-4009
Provider Enumeration Date:
12/02/2005

Additional Information

Authorized Official

Authorized Official Last Name:
DIMARCO
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
F
Authorized Official Title or Position:
MANAGING PARTNER
Authorized Official Telephone Number:
610-525-3162

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  6000005771 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 226221 . This is a "ADVANTRA CARELINK" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 2272955 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4344350 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 5164 . This is a "BC/BS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 8704805 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 90171 . This is a "HEALTH SENIOR PARTNERS" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 642648400 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 90171 . This is a "BCBS" identifier , issued by the state of ( FM ) . This identifiers is of the category "OTHER".
  • Identifier: 90003799 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: P2723785 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 41731600 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8200594 . This is a "UNITED EVERCARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: DM1174 , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 540H104220 . This is a "BCBS" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 1861130 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 625683800 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 010145988 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 54432383 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 629315 . This is a "ANTHEM BCBS" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




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