1003161860 NPI number — MR. CHARLES E WARRINGTON JR. CRNP

Table of content: MR. CHARLES E WARRINGTON JR. CRNP (NPI 1003161860)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003161860 NPI number — MR. CHARLES E WARRINGTON JR. CRNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WARRINGTON
Provider First Name:
CHARLES
Provider Middle Name:
E
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
JR.
Provider Credential Text:
CRNP
Provider Gender Code:
M

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:
1003161860
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/07/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
111 S 11TH ST
Provider Second Line Business Mailing Address:
GIBBON BLDG. HOSPITAL ADMIN. SUITE 2210
Provider Business Mailing Address City Name:
PHILADELPHIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19107-4824
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-955-1349
Provider Business Mailing Address Fax Number:
215-955-1935

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1100 WALNUT ST FL 7
Provider Second Line Business Practice Location Address:
MEDICAL OFFICE BUILDING
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19107-4944
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-955-2165
Provider Business Practice Location Address Fax Number:
215-923-7957
Provider Enumeration Date:
07/18/2012

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LA2100X , with the licence number:  SP011375 , 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)





Copyright © 2007-2025 www.npivalidator.com