1245350248 NPI number — MR. CHARLES S. MURPHY PA

Table of content: MR. CHARLES S. MURPHY PA (NPI 1245350248)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245350248 NPI number — MR. CHARLES S. MURPHY PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MURPHY
Provider First Name:
CHARLES
Provider Middle Name:
S.
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
PA
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:
1245350248
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/13/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 820933
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PHILADELPHIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19182-0933
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-233-9700
Provider Business Mailing Address Fax Number:
215-233-9710

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1722 BETHLEHEM PIKE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FLOURTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19031-1644
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-233-9700
Provider Business Practice Location Address Fax Number:
215-233-9710
Provider Enumeration Date:
03/31/2007

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: 208G00000X , with the licence number:  009341 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363AM0700X , with the licence number: 009341-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363AM0700X , with the licence number: MA-055936 , 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: CD4829 . This is a "TPI RAILROAD MEDICARE GROUP" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1007278000 . This is a "TPI MEDICAID GROUP ID" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 597586 . This is a "TPI MEDICARE GROUP PTAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com