Organization
PROSTAT, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID EUGENE SHELLY (COO)
(570) 225-7090
Entity
Organization
Contact information
Practice address
1901 BERNVILLE RD, READING, PA 19601-1113
(610) 736-9000
(610) 736-9006
Mailing address
395 E BROAD ST, TAMAQUA, PA 18252-2145
(570) 225-7090
(570) 225-7097
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
23393601
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1024232050001
—
PA
05
—
1024232050002
—
PA
05
—
1024232050003
—
PA
Enumeration date
10/12/2012
Last updated
10/12/2012
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