Healthcare Provider Details

I. General information

NPI: 1689674558
Provider Name (Legal Business Name): TOTAL HOSPITAL CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 WOODSVIEW DR
GARNET VALLEY PA
19061-1227
US

IV. Provider business mailing address

11 WOODSVIEW DR
GARNET VALLEY PA
19061-1227
US

V. Phone/Fax

Practice location:
  • Phone: 610-372-6617
  • Fax:
Mailing address:
  • Phone: 610-372-6617
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DAMIAN CORNACCHIA
Title or Position: HEAD DOCTOR
Credential: D.O.
Phone: 610-372-6617