1013348028 NPI number — PROVIDER PARTNERS CARE MANAGEMENT LP

Table of content: (NPI 1013348028)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013348028 NPI number — PROVIDER PARTNERS CARE MANAGEMENT LP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PROVIDER PARTNERS CARE MANAGEMENT LP
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:
PHILADELPHIA NURSE PRACTITIONERS, LP
Provider Other Organization Name Type Code:
4
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:
1013348028
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/15/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
785 ELKRIDGE LANDING RD STE 300
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LINTHICUM
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21090-2958
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-967-2097
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
785 ELKRIDGE LANDING RD STE 300
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LINTHICUM
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21090-2958
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-967-2097
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/02/2013

Additional Information

Authorized Official

Authorized Official Last Name:
PERSINGER
Authorized Official First Name:
KEITH
Authorized Official Middle Name:
D
Authorized Official Title or Position:
CHIEF OPERATING OFFICER
Authorized Official Telephone Number:
443-275-9800

Provider Taxonomy Codes

  • Taxonomy code: 363L00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2024 www.npivalidator.com