Healthcare Provider Details

I. General information

NPI: 1982844627
Provider Name (Legal Business Name): PAIN CARE ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2009
Last Update Date: 02/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1205 LANGHORNE-NEWTOWN ROAD
LANGHORNE PA
19047-1219
US

IV. Provider business mailing address

1205 LANSDOWNE-NEWTOWN ROAD
LANGHORNE PA
19047-1219
US

V. Phone/Fax

Practice location:
  • Phone: 215-710-2196
  • Fax:
Mailing address:
  • Phone: 215-710-2196
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ERICH EVERTS
Title or Position: DIRECTOR
Credential: MD
Phone: 215-710-2196