Organization
PRIMARY HOME CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JERRY DRISCOLL NP (PRESIDENT)
(215) 635-3151
Entity
Organization
Contact information
Practice address
8080 OLD YORK RD, ELKINS PARK, PA 19027-1421
(215) 635-3151
Mailing address
8080 OLD YORK RD, ELKINS PARK, PA 19027-1421
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
SP008740
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SP008740
NP LICENCE
PA
Enumeration date
06/15/2006
Last updated
08/22/2020
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