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Organization

PMSI DIVISION OF HEMATOLOGY

Active
Parent organization
POTTSTOWN MEDICAL SPECIALISTS
Other names
POTTSTOWN MEDICAL SPECIALISTS HEM ONC
Organization subpart
Yes

Provider details

NPI number
Legal business name
POTTSTOWN MEDICAL SPECIALISTS
Authorized official
SHANA M ENOCHS (CREDENTIALING SPECIALIST)
(610) 327-4200
Entity
Organization

Contact information

Practice address
1591 MEDICAL DRIVE, POTTSTOWN, PA 19464
(610) 326-8005
(610) 327-9629
Mailing address
1610 MEDICAL DRIVE, SUITE 310, POTTSTOWN, PA 19464
(610) 327-4200
(610) 327-8160

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
MD065910L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0859307000
KEYSTONE HMO
PA
01
919533
BLUE SHIELD ASSIGN ACCT
PA
Enumeration date
03/20/2007
Last updated
07/14/2016
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