MEDICARE: MS. RACHEL SAMBLE PA-C

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	363A00000X	Physician Assistant
2	363A00000X	Physician Assistant		MD

General Provider Information

NPI Number	:	1912376997
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. RACHEL SAMBLE PA-C

Provider Business Mailing Address
First Line	:	922 E HECTOR ST
Second Line	:
City	:	CONSHOHOCKEN
State	:	PA
Zip	:	19428-2308
Country	:	US
Telephone Number	:	267-374-5562
Fax Number	:

Provider Business Practice Location Address
First Line	:	701 E MARSHALL ST
Second Line	:
City	:	WEST CHESTER
State	:	PA
Zip	:	19380-4412
Country	:	US
Telephone Number	:	410-554-2000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/18/2015
Last Update Date	:	03/11/2026

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