Healthcare Provider Details
I. General information
NPI: 1629076070
Provider Name (Legal Business Name): MONTGOMERY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/11/2005
Last Update Date: 05/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1301 POWELL ST
NORRISTOWN PA
19401-3323
US
IV. Provider business mailing address
1301 POWELL ST P.O. BOX 0992
NORRISTOWN PA
19401-3323
US
V. Phone/Fax
- Phone: 610-270-2000
- Fax:
- Phone: 610-270-2000
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 273R00000X |
| Taxonomy | Psychiatric Hospital Unit |
| License Number | 910410 |
| License Number State | PA |
VIII. Authorized Official
Name: MR.
EDWARD
W
LADELY
Title or Position: SENIOR VICE PRESIDENT AND CFO
Credential:
Phone: 610-270-2067