1215197942 NPI number — CROZER CHESTER MEDICAL CENTER

Table of content: (NPI 1215197942)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215197942 NPI number — CROZER CHESTER MEDICAL CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CROZER CHESTER MEDICAL 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:
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:
1215197942
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/12/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
ONE MEDICAL CENTER BOULEVARD
Provider Second Line Business Mailing Address:
PEARL HALL
Provider Business Mailing Address City Name:
UPLAND
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19013-0000
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-447-2271
Provider Business Mailing Address Fax Number:
610-447-2215

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
ONE MEDICAL CENTER BOULEVARD
Provider Second Line Business Practice Location Address:
PEARL HALL
Provider Business Practice Location Address City Name:
UPLAND
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19013-0000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-447-2271
Provider Business Practice Location Address Fax Number:
610-447-2215
Provider Enumeration Date:
06/16/2008

Additional Information

Authorized Official

Authorized Official Last Name:
HAMMELL
Authorized Official First Name:
DRU
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
610-447-2271

Provider Taxonomy Codes

  • Taxonomy code: 261QF0050X , with the licence number:  037201 , 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)

  • Identifier: 1007605830044 . This is a "KEYSTONE MERCY HEALTH PLAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0073794903 . This is a "AMERICHOICE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1007605830044 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com