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Organization
PENNSYLVANIA CARE, LLC
Active
Organization
PENNSYLVANIA CARE, LLC
Active
Other names
Miners Medical
Organization subpart
No
Provider details
NPI number
Authorized official
ROBYN TANIS (EXECUTIVE DIRECTOR OF CONTRACT MGMT)
(856) 533-8762
Entity
Organization
Contact information
Practice address
43 S MAIN ST, ASHLEY, PA 18706-1506
(570) 822-5145
(570) 822-5147
Mailing address
1317 ROUTE 73 STE 200, MOUNT LAUREL, NJ 08054-2202
(856) 429-6111
(570) 822-5147
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
407058
PA
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
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Other
Enumeration date
02/11/2011
Last updated
07/18/2022
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