1194769596 NPI number — CHARLES F. GOREY DO

Table of content: JENNY GEMPELER (NPI 1720581713)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194769596 NPI number — CHARLES F. GOREY DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GOREY
Provider First Name:
CHARLES
Provider Middle Name:
F.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DO
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1194769596
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/13/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
730 S HANOVER ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
POTTSTOWN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19465-7520
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-323-6835
Provider Business Mailing Address Fax Number:
610-323-4154

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
730 S HANOVER ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
POTTSTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19465-7520
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-323-6835
Provider Business Practice Location Address Fax Number:
610-323-4154
Provider Enumeration Date:
06/15/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  OS008196L , 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: 080135388 . This is a "RRM" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 11046985 . This is a "MULTIPLAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 5422945 . This is a "CIGNA HMO/PPO" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0510292 . This is a "AETNA HMO" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0810343000 . This is a "AMERIHEALTH/INTERCOUNTY" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 16452-OS008196L . This is a "HEALTH PARTNERS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 367800 . This is a "PHCS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0015286300002 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 785606 . This is a "HIGHMARK BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 4658662 . This is a "AETNA PPO" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0152863002 . This is a "AMERICHOICE (UHC MA PLAN)" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 2124458 . This is a "ALLIANCE/OPT CHC (MAMSI)" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0810343000 . This is a "IBC - PC/KHPE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1028461 . This is a "KEYSTONE MERCY" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 10927765 . This is a "CAQH ID#" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com