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Organization
PMA MEDICAL SPECIALISTS
Active
Organization
PMA MEDICAL SPECIALISTS
Active
Other names
Prime Health Network
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY B RIMMER (EXECUTIVE DIRECTOR)
(610) 933-8000
Entity
Organization
Contact information
Practice address
450 PARK WAY, SUITE 300, BROOMALL, PA 19008-4202
(484) 422-8080
(484) 422-8073
Mailing address
450 PARK WAY, SUITE 300, BROOMALL, PA 19008-4202
(484) 422-8080
(484) 422-8073
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
789590
PA
207R00000X
Internal Medicine Physician
Primary
789590
PA
225100000X
Physical Therapist
PT024201
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0007049930005
—
PA
01
—
CA2851
RAILROAD MEDICARE
PA
01
—
CA4343
RAILROAD MEDICARE
PA
01
—
CC4778
RAILROAD MEDICARE
PA
01
—
CC5809
RAILROAD MEDICARE
PA
01
—
CD5679
RAILROAD MEDICARE
PA
01
—
CI1897
RAILROAD MEDICARE
PA
Enumeration date
06/02/2005
Last updated
03/22/2017
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