Organization
BERKSHIRE FAMILY MEDICINE, PC
Active
Other names
Comprehensive Athletic Training Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AMY LYNN DIEHM (BILLING MANAGER)
(610) 685-9600
Entity
Organization
Contact information
Practice address
1350 BROADCASTING RD, STE 201, WYOMISSING, PA 19610-3220
(610) 685-9600
(610) 685-6700
Mailing address
1350 BROADCASTING RD, STE 201, WYOMISSING, PA 19610-3220
(610) 685-9600
(610) 685-6700
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1642082
PA BLUE SHIELD
—
01
—
244757
HEALTH ASSURANCE HEALTH A
—
01
—
3000329
KEYSTONE HEALTH PLAN CENT
—
01
—
50039846
CAPITAL BLUE CROSS
—
Enumeration date
09/13/2005
Last updated
09/12/2008
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