1699321570 NPI number — GRAND VIEW HOSPITAL

Table of content: DR. JOE MAC KELLER DDS MS (NPI 1255435590)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699321570 NPI number — GRAND VIEW HOSPITAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GRAND VIEW HOSPITAL
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:
6
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:
1699321570
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/27/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1111
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HARLEYSVILLE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19438-0907
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-453-4995
Provider Business Mailing Address Fax Number:
215-453-4646

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
700 LAWN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SELLERSVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18960-1548
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-453-4118
Provider Business Practice Location Address Fax Number:
215-453-4139
Provider Enumeration Date:
08/15/2019

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ANDERSON
Authorized Official First Name:
ARTHUR
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
215-453-4120

Provider Taxonomy Codes

  • Taxonomy code: 2084N0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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