1427369404 NPI number — COATESVILLE CARDIOLOGY CLINIC LLC

Table of content: (NPI 1427369404)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427369404 NPI number — COATESVILLE CARDIOLOGY CLINIC LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COATESVILLE CARDIOLOGY CLINIC LLC
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:
1427369404
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/11/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 13579
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
READING
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19612-3579
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3025 C G ZINN RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
THORNDALE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19372-1131
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-384-2211
Provider Business Practice Location Address Fax Number:
610-384-2340
Provider Enumeration Date:
06/24/2010

Additional Information

Authorized Official

Authorized Official Last Name:
EHINGER
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
Authorized Official Title or Position:
SR VP FINANCIAL OPERATIONS
Authorized Official Telephone Number:
484-628-4681

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207UN0901X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 102536600001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com