Organization
FOULKEWAYS AT GWYNEDD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. EDNA MARIE CRISTINZIO (CHIEF FINANCIAL OFFICER)
(215) 283-7002
Entity
Organization
Contact information
Practice address
1120 MEETINGHOUSE RD, GWYNEDD, PA 19436-1000
(216) 643-2200
(215) 646-2917
Mailing address
1120 MEETINGHOUSE RD, GWYNEDD, PA 19436-1000
(216) 643-2200
(215) 646-2917
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
144230
PA
314000000X
Skilled Nursing Facility
Primary
060902
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002612
HIGHMARK MEDICARE SERVICE
PA
01
—
5862
HIGHMARK BLUE SHIELD
PA
Enumeration date
05/31/2005
Last updated
11/05/2007
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