Healthcare Provider Details

I. General information

NPI: 1356437420
Provider Name (Legal Business Name): DELAWARE COUNTY MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 01/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 NORTH LANSDOWNE AVENUE
DREXEL HILL PA
19026
US

IV. Provider business mailing address

501 NORTH LANSDOWNE AVENUE
DREXEL HILL PA
19026
US

V. Phone/Fax

Practice location:
  • Phone: 610-284-8100
  • Fax: 610-619-7331
Mailing address:
  • Phone: 610-284-8100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number041801
License Number StatePA

VIII. Authorized Official

Name: MR. PATRICK GAVIN
Title or Position: COO
Credential:
Phone: 610-338-8228