Organization
PMSI DIVISION OF RHEUMATOLOGY
Active
Parent organization
POTTSTOWN MEDICAL SPECIALISTS, INC.
Other names
POTTSTOWN MEDICAL SPECIALISTS RHEUMATOLOGY
Organization subpart
Yes
Provider details
NPI number
Legal business name
POTTSTOWN MEDICAL SPECIALISTS, INC.
Authorized official
SHANA M ENOCHS (CREDENTIALING SPECIALIST)
(610) 327-4200
Entity
Organization
Contact information
Practice address
1566 MEDICAL DR, SUITE 104, POTTSTOWN, PA 19464-3229
(484) 945-0075
(484) 945-0781
Mailing address
1601 MEDICAL DR, POTTSTOWN, PA 19464-3241
(610) 327-4200
(610) 327-8160
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
OS009934L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1392933
BLUE SHIELD ASSIGN ACCT
PA
01
—
2082006000
KEYSTONE HMO
—
Enumeration date
03/20/2007
Last updated
07/14/2016
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