MEDICARE: MERAKEY CHILDRENS SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568685378
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MERAKEY CHILDRENS SERVICES

Provider Business Mailing Address
First Line	:	620 GERMANTOWN PIKE
Second Line	:
City	:	LAFAYETTE HILL
State	:	PA
Zip	:	19444-1810
Country	:	US
Telephone Number	:	215-836-3131
Fax Number	:	215-273-5975

Provider Business Practice Location Address
First Line	:	639 E CHURCH LN
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19144-1411
Country	:	US
Telephone Number	:	215-836-3131
Fax Number	:	215-273-5975

Authorized Official
Title or Position	:	CORP SR. DIRECTOR OF BUSINESS OPS
Name	:	MR. NORMAN E TILSON JR.
Credential	:
Telephone Number	:	215-836-3131

Provider Enumeration Date	:	04/10/2007
Last Update Date	:	01/25/2024

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