Healthcare Provider Details

I. General information

NPI: 1639419252
Provider Name (Legal Business Name): LANSDALE HOSPITAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2013
Last Update Date: 02/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1290 ALLENTOWN RD SUITE A
LANSDALE PA
19446-4177
US

IV. Provider business mailing address

1290 ALLENTOWN RD SUITE A
LANSDALE PA
19446-4177
US

V. Phone/Fax

Practice location:
  • Phone: 267-263-2894
  • Fax: 267-263-2881
Mailing address:
  • Phone: 267-263-2894
  • Fax: 267-263-2881

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. LARRY MERLIS
Title or Position: PRESIDENT/CEO
Credential:
Phone: 215-481-5837