Organization
HR PHYSICIAN SERVICES
Active
Other names
Redeemer Medical Supportive Care
Organization subpart
No
Provider details
NPI number
Authorized official
RUSSELL R WAGNER (EXECUTIVE VICE PRESIDENT FINANCE)
(215) 856-1114
Entity
Organization
Contact information
Practice address
8580 VERREE RD, PHILADELPHIA, PA 19111-1370
(215) 214-3815
(215) 214-3816
Mailing address
12265 TOWNSEND RD, PHILADELPHIA, PA 19154-1201
Taxonomy
Speciality
Code
Description
License number
State
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
OS016324
PA
Other
Enumeration date
10/06/2015
Last updated
10/13/2015
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