# SENIORWELL OF PENNSYLVANIA, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** SeniorWell of Pennsylvania, LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538718556
- **Authorized official:** JOHN MARONEY (CEO)
- **Authorized official phone:** (844) 882-3127

## Contact information

- **Practice address:** 2929 ARCH ST STE 1700, PHILADELPHIA, PA 19104-7327
- **Practice address phone:** (844) 882-3127
- **Practice address fax:** (844) 246-5875
- **Mailing address:** 2100 E LAKE COOK RD, BUFFALO GROVE, IL 60089-1999
- **Mailing address phone:** (844) 882-3127
- **Mailing address fax:** (844) 246-5875

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | Yes |
| 122300000X | Dentist | — | — | Yes |
| 152W00000X | Optometrist | — | NULL | — |
| 152W00000X | Optometrist | — | — | — |
| 231H00000X | Audiologist | — | NULL | — |
| 231H00000X | Audiologist | — | — | — |

## Other

- **Enumeration date:** 09/11/2019
- **Last updated:** 09/11/2019