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Organization

VALLEY PAIN CENTER, L.L.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARIE HENNIGAR (ADMINISTRATIVE DIRECTOR)
(215) 947-7992
Entity
Organization

Contact information

Practice address
1800 BYBERRY RD, SUITE 1101, HUNTINGDON VALLEY, PA 19006-3518
(215) 947-7992
(215) 947-7969
Mailing address
1800 BYBERRY RD, SUITE 1101, HUNTINGDON VALLEY, PA 19006-3518
(215) 947-7992
(215) 947-7969

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
17161501
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0001119000
IBC
PA
01
3415134
AETNA
PA
Enumeration date
05/25/2006
Last updated
08/22/2020
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