Organization
PMSI DIVISION OF PULMONARY
Active
Parent organization
POTTSTOWN MEDICAL SPECIALISTS
Other names
POTTSTOWN MEDICAL SPECIALISTS PULMONARY
Organization subpart
Yes
Provider details
NPI number
Legal business name
POTTSTOWN MEDICAL SPECIALISTS
Authorized official
SHANA M ENOCHS (CREDENTIALING SPECIALIST)
(610) 327-4200
Entity
Organization
Contact information
Practice address
1591 MEDICAL DRIVE, POTTSTOWN, PA 19464
(610) 326-8005
(484) 945-0572
Mailing address
1610 MEDICAL DRIVE, SUITE 310, POTTSTOWN, PA 19464
(610) 327-4200
(484) 945-0572
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
OS006542L
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0859983000
KEYSTONE HMO
PA
01
—
919367
BLUE SHIELD ASSIGN ACCT
PA
Enumeration date
03/21/2007
Last updated
07/14/2016
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