Healthcare Provider Details

I. General information

NPI: 1306476924
Provider Name (Legal Business Name): TOWER HEALTH MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2020
Last Update Date: 11/26/2021
Certification Date: 11/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8835 GERMANTOWN AVE
PHILADELPHIA PA
19118-2718
US

IV. Provider business mailing address

PO BOX 13579
READING PA
19612-3579
US

V. Phone/Fax

Practice location:
  • Phone: 484-628-7700
  • Fax: 484-628-7766
Mailing address:
  • Phone: 484-628-1324
  • Fax: 484-334-7026

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0008X
TaxonomyHepatology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code204F00000X
TaxonomyTransplant Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: ROBERT EHINGER
Title or Position: SR VP FINANCIAL OPERATIONS
Credential:
Phone: 484-628-1324