1689791766 NPI number — GENERAL HEALTHCARE RESOURCES, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689791766 NPI number — GENERAL HEALTHCARE RESOURCES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GENERAL HEALTHCARE RESOURCES, 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:
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:
1689791766
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
43 CHESTER AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COATESVILLE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19320-3667
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-384-3198
Provider Business Mailing Address Fax Number:
610-384-3198

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2250 HICKORY RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PLYMOUTH MEETING
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19462-1047
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-834-1122
Provider Business Practice Location Address Fax Number:
610-834-7525
Provider Enumeration Date:
03/23/2007

Additional Information

Authorized Official

Authorized Official Last Name:
YATES
Authorized Official First Name:
GWENDOLYN
Authorized Official Middle Name:
RAE
Authorized Official Title or Position:
LPN
Authorized Official Telephone Number:
484-995-0333

Provider Taxonomy Codes

  • Taxonomy code: 251J00000X , with the licence number:  PN093077L , 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)





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