Organization
PROSPECT CCMC, LLC
Active
Other names
Prospect CCMC, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT JON ELDERS (SECRETARY)
(714) 788-1249
Entity
Organization
Contact information
Practice address
800 MACDADE BLVD, COLLINGDALE, PA 19023-3826
(610) 915-3496
Mailing address
800 MACDADE BLVD, COLLINGDALE, PA 19023-3826
(610) 915-3496
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
06/14/2019
Last updated
01/15/2021
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