Healthcare Provider Details

I. General information

NPI: 1467510560
Provider Name (Legal Business Name): EAGLEVILLE HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 02/11/2021
Certification Date: 02/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 EAGLEVILLE RD
EAGLEVILLE PA
19403-1829
US

IV. Provider business mailing address

100 EAGLEVILLE RD
EAGLEVILLE PA
19403-1829
US

V. Phone/Fax

Practice location:
  • Phone: 610-539-6000
  • Fax: 610-539-6249
Mailing address:
  • Phone: 610-539-6000
  • Fax: 610-539-6249

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code276400000X
TaxonomySubstance Use Disorder Rehabilitation Hospital Unit
License Number051001
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number051001
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code284300000X
TaxonomySpecial Hospital
License Number051001
License Number StatePA

VIII. Authorized Official

Name: MICHAEL MCGLONE
Title or Position: DIRECTOR FINANCE
Credential:
Phone: 267-291-2210