Healthcare Provider Details

I. General information

NPI: 1275515587
Provider Name (Legal Business Name): LIMERICK PET ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2005
Last Update Date: 03/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 W LINFIELD TRAPPE RD
LIMERICK PA
19468-4278
US

IV. Provider business mailing address

486 NORRISTOWN RD SUITE 133
BLUE BELL PA
19422-2353
US

V. Phone/Fax

Practice location:
  • Phone: 610-495-0060
  • Fax: 610-495-4798
Mailing address:
  • Phone: 610-993-1640
  • Fax: 610-993-1651

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. ANDREW KREAMER ROOKE JR.
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 610-993-1640