Healthcare Provider Details

I. General information

NPI: 1699285213
Provider Name (Legal Business Name): PRESBYTERIAN RETIREMENT CORPORATION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2017
Last Update Date: 02/20/2024
Certification Date: 02/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 SPANISH FORT BLVD
SPANISH FORT AL
36527-5018
US

IV. Provider business mailing address

420 DELAWARE DR
FORT WASHINGTON PA
19034-2711
US

V. Phone/Fax

Practice location:
  • Phone: 251-626-7007
  • Fax: 251-626-8529
Mailing address:
  • Phone: 267-787-4097
  • Fax: 215-699-2065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: SUSAN AHERN
Title or Position: SVP, CFO
Credential:
Phone: 215-661-8330