1306066717 NPI number — SENIOR CARE CENTERS OF PENNSYLVANIA, INC.

Table of content: (NPI 1306066717)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306066717 NPI number — SENIOR CARE CENTERS OF PENNSYLVANIA, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SENIOR CARE CENTERS OF PENNSYLVANIA, INC.
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:
SENIOR CARE OF HORSHAM
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:
1306066717
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/06/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6 NESHAMINY INTERPLEX DR
Provider Second Line Business Mailing Address:
SUITE 401
Provider Business Mailing Address City Name:
TREVOSE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19053-6964
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-642-6600
Provider Business Mailing Address Fax Number:
215-642-6610

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
111 GIBRALTAR RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HORSHAM
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19044-2303
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-443-5300
Provider Business Practice Location Address Fax Number:
215-443-5301
Provider Enumeration Date:
04/26/2007

Additional Information

Authorized Official

Authorized Official Last Name:
HOCKENBURY
Authorized Official First Name:
DEBORA
Authorized Official Middle Name:
Authorized Official Title or Position:
CONTRACTS MANAGER
Authorized Official Telephone Number:
215-642-6600

Provider Taxonomy Codes

  • Taxonomy code: 261QA0600X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 385H00000X , with the licence number: 282520 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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