1407430291 NPI number — AVENUES RECOVERY MEDICAL CENTER AT VALLEY FORGE

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 1407430291 NPI number — AVENUES RECOVERY MEDICAL CENTER AT VALLEY FORGE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AVENUES RECOVERY MEDICAL CENTER AT VALLEY FORGE
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:
VALLEY FORGE MEDICAL CENTER
Provider Other Organization Name Type Code:
3
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:
1407430291
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/30/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
850 TOWBIN AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAKEWOOD
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08701-5928
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
732-886-6202
Provider Business Mailing Address Fax Number:
732-797-9303

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1033 W GERMANTOWN PIKE
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:
19403-3905
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-539-8500
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/08/2021

Additional Information

Authorized Official

Authorized Official Last Name:
LEVIN
Authorized Official First Name:
BEN
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
732-886-6202

Provider Taxonomy Codes

  • Taxonomy code: 276400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 282N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 324500000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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