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NPI Code Detail

MEDICARE: MERAKEY PENNSYLVANIA

MEDICARE: MERAKEY PENNSYLVANIA
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
1251S00000XCommunity/Behavioral Health Agency

Other Identifiers

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

General Provider Information

NPI Number : 1932378205
Entity Type Code : Organization
Provider Name (Legal Business Name) : MERAKEY PENNSYLVANIA
Provider Business Mailing Address
First Line : 4391 STURBRIDGE DR
Second Line :
City : HARRISBURG
State : PA
Zip : 17110-3673
Country : US
Telephone Number : 215-836-3131
Fax Number : 215-273-5975
Provider Business Practice Location Address
First Line : 209 S TULPEHOCKEN ST
Second Line :
City : PINE GROVE
State : PA
Zip : 17963-1036
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 : 02/21/2008
Last Update Date : 06/16/2018

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Directions to “MERAKEY PENNSYLVANIA ” Practice Location

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