1265470850 NPI number — ABINGTON RADIATION ONCOLOGY, PC

Table of content: (NPI 1265470850)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265470850 NPI number — ABINGTON RADIATION ONCOLOGY, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ABINGTON RADIATION ONCOLOGY, PC
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:
AMH RADIATION MEDICINE ASSOCIATES, PC
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:
1265470850
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/20/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P O BOX 13700-1132
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:
19191-0001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-292-0847
Provider Business Mailing Address Fax Number:
717-292-0847

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1200 OLD YORK RD
Provider Second Line Business Practice Location Address:
DEPT OF RADIATION ONCLOLOY
Provider Business Practice Location Address City Name:
ABINGTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19001-3720
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-481-2800
Provider Business Practice Location Address Fax Number:
215-481-6741
Provider Enumeration Date:
06/03/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MATTHEWS
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
H
Authorized Official Title or Position:
BILLING MANAGER
Authorized Official Telephone Number:
717-292-0847

Provider Taxonomy Codes

  • Taxonomy code: 2085R0001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0427403000 . This is a "IBC PERSONAL CHOICE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 54488 . This is a "AETNA/US HEALTHCARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: CF4335 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0011874600001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: AM0000604904 . This is a "PA BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1029087 . This is a "KEYSTONE MERCY HEALTH PLA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0427403000 . This is a "KEYSTONE HEALTH PLAN EAST" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".