Organization
POTTSTOWN HOSPITAL COMPANY LLC
Active
Other names
Coventry Medical Group - Peds
Organization subpart
No
Provider details
NPI number
Authorized official
GARY D NEWSOME (PRESIDENT)
(615) 373-9600
Entity
Organization
Contact information
Practice address
1610 MEDICAL DR, POTTSTOWN, PA 19464-3292
(610) 326-8660
(610) 326-8408
Mailing address
730 S HANOVER ST, POTTSTOWN, PA 19465-7520
(610) 323-6835
(610) 323-4154
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007517440011
—
PA
Enumeration date
08/11/2005
Last updated
07/21/2022
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