1669838900 NPI number — CROZER-KEYSTONE HEALTH SYSTEM

Table of content: (NPI 1669838900)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669838900 NPI number — CROZER-KEYSTONE HEALTH SYSTEM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CROZER-KEYSTONE HEALTH SYSTEM
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:
CROZER-KEYSTONE HEALTHY START
Provider Other Organization Name Type Code:
5
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:
1669838900
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/04/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2600 W 9TH ST
Provider Second Line Business Mailing Address:
1ST FLOOR
Provider Business Mailing Address City Name:
CHESTER
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19013-2040
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-497-7344
Provider Business Mailing Address Fax Number:
610-497-7472

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2600 W 9TH ST
Provider Second Line Business Practice Location Address:
1ST FLOOR
Provider Business Practice Location Address City Name:
CHESTER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19013-2040
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-497-7460
Provider Business Practice Location Address Fax Number:
610-497-7472
Provider Enumeration Date:
12/31/2015

Additional Information

Authorized Official

Authorized Official Last Name:
CRAIG
Authorized Official First Name:
JOANNE
Authorized Official Middle Name:
DAWN
Authorized Official Title or Position:
ADMINSITRATIVE DIRECTOR
Authorized Official Telephone Number:
610-497-7344

Provider Taxonomy Codes

  • Taxonomy code: 251B00000X ; 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