Healthcare Provider Details

I. General information

NPI: 1386637734
Provider Name (Legal Business Name): MONTGOMERY COUNTY MH-MR EMERGENCY SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2005
Last Update Date: 08/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 BEECH DR
NORRISTOWN PA
19403-5421
US

IV. Provider business mailing address

50 BEECH DR
NORRISTOWN PA
19403-5421
US

V. Phone/Fax

Practice location:
  • Phone: 610-279-6100
  • Fax: 610-279-0978
Mailing address:
  • Phone: 610-279-6100
  • Fax: 610-279-0978

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code341600000X
TaxonomyAmbulance
License Number03261
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number173410
License Number StatePA

VIII. Authorized Official

Name: DEBORAH SHANLEY
Title or Position: ADMINISTRATIVE ASSISTANT
Credential:
Phone: 610-279-6100