1043529878 NPI number — NORRISTOWN STATE HOSPITAL PEER EDUCATION CENTER

Table of content: (NPI 1043529878)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043529878 NPI number — NORRISTOWN STATE HOSPITAL PEER EDUCATION CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NORRISTOWN STATE HOSPITAL PEER EDUCATION CENTER
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:
1043529878
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/28/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1211 CHESTNUT ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PHILADELPHIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19107-4103
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
267-507-3823
Provider Business Mailing Address Fax Number:
215-636-6309

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1001 STERIGERE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORRISTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19401-5300
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-313-5841
Provider Business Practice Location Address Fax Number:
610-313-5772
Provider Enumeration Date:
09/28/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
DINWIDDIE
Authorized Official First Name:
WILLIAM
Authorized Official Middle Name:
S.
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
267-507-3823

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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