Healthcare Provider Details
I. General information
NPI: 1760501290
Provider Name (Legal Business Name): HEALTH ACCESS NETWORK
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/28/2007
Last Update Date: 10/23/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1 MEDICAL CENTER BLVD
CHESTER PA
19013-3902
US
IV. Provider business mailing address
PO BOX 8500-6355
PHILADELPHIA PA
19178-0001
US
V. Phone/Fax
- Phone: 610-447-2000
- Fax:
- Phone: 610-497-7520
- Fax: 610-497-7525
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
BRAD
PRECHTL
Title or Position: PRESIDENT
Credential:
Phone: 610-338-8386