Organization
COUNTY OF MONTGOMERY HOUSE STAFF
Active
Parent organization
PARKHOUSE PROVIDENCE POINTE
Other names
PARKHOUSE PROVIDENCE POINTE
Organization subpart
Yes
Provider details
NPI number
Legal business name
PARKHOUSE PROVIDENCE POINTE
Authorized official
MELANIE DEBLASE DON (ADMINISTRATOR)
(610) 792-2224
Entity
Organization
Contact information
Practice address
1600 BLACK ROCK RD, ROYERSFORD, PA 19468-3147
(610) 792-2224
Mailing address
1600 BLACK ROCK RD, ROYERSFORD, PA 19468-3147
(610) 792-2224
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
—
—
363AM0700X
Medical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010062489
RAILROAD #
PA
01
—
080140805
RAILROAD
PA
01
—
080154916
RAILROAD #
PA
01
—
1093753949
NPI
PA
01
—
1194769596
NPI
PA
01
—
1417904897
NPI
PA
01
—
1710029335
NPI
PA
01
—
177908
PROVIDER #
PA
01
—
1962412791
NPI
PA
01
—
970001552
RAILROAD
PA
01
—
MA000404L
LICENSE
PA
01
—
MA000727L
LICENSE
PA
01
—
OS006559L
LICENSE
PA
01
—
OS008196L
LICENSE
PA
01
—
OS008998L
LICENSE
PA
01
—
P00353119
RAILROAD
PA
01
—
P00353128
RAILROAD
PA
Enumeration date
05/19/2008
Last updated
05/22/2008
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