Healthcare Provider Details

I. General information

NPI: 1427045541
Provider Name (Legal Business Name): NEW HERITAGE TOWERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2005
Last Update Date: 09/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 VETERANS LN
DOYLESTOWN PA
18901-6716
US

IV. Provider business mailing address

101 E COUNTY LINE RD SUITE 200
HATBORO PA
19040-1229
US

V. Phone/Fax

Practice location:
  • Phone: 215-345-4300
  • Fax: 215-345-4927
Mailing address:
  • Phone: 215-354-9586
  • Fax: 215-354-1435

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number085502
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier5161500
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerAETNA PROVIDER NUMBER
# 2
Identifier0010035800001
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer
# 3
Identifier0005994000
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerIBC PROVIDER ID

VIII. Authorized Official

Name: MR. STEVEN THOMAS CHERRY
Title or Position: EXECUTIVE DIRECTOR
Credential: NHA
Phone: 215-345-4300