1518654474 NPI number — ADULT GERIATRIC OSTEOPATHIC MEDICAL CARE, LLC

Table of content: MS. PATRICIA HEIN WARRICK M.S., LMHC (NPI 1558408567)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518654474 NPI number — ADULT GERIATRIC OSTEOPATHIC MEDICAL CARE, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADULT GERIATRIC OSTEOPATHIC MEDICAL CARE, 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:
Provider Other Last Name:
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Provider Other Credential Text:
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NPI Number Information

NPI Number:
1518654474
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/20/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2610 CENTURY AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRISTOL
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19007-1710
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:
2610 CENTURY AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BRISTOL
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19007-1710
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-584-0815
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/20/2023

Additional Information

Authorized Official

Authorized Official Last Name:
TREXLER
Authorized Official First Name:
AMANDA
Authorized Official Middle Name:
Authorized Official Title or Position:
BILLING MANAGER
Authorized Official Telephone Number:
267-300-2407

Provider Taxonomy Codes

  • Taxonomy code: 207QG0300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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