Organization
ST MARY MANOR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL CZEKNER (CHIEF FINANCIAL OFFICER)
(215) 368-0900
Entity
Organization
Contact information
Practice address
701 LANSDALE AVE, LANSDALE, PA 19446-2958
(215) 368-0900
(215) 368-5254
Mailing address
701 LANSDALE AVE, LANSDALE, PA 19446-2958
(215) 368-0900
(215) 368-5254
Taxonomy
Speciality
Code
Description
License number
State
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
Primary
451402
PA
Other
Enumeration date
11/29/2006
Last updated
11/10/2008
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