Healthcare Provider Details

I. General information

NPI: 1225905383
Provider Name (Legal Business Name): PENNYPACK ACQUISITIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2025
Last Update Date: 10/22/2025
Certification Date: 10/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8015 LAWNDALE AVE
PHILADELPHIA PA
19111-1507
US

IV. Provider business mailing address

8015 LAWNDALE AVE
PHILADELPHIA PA
19111-1507
US

V. Phone/Fax

Practice location:
  • Phone: 215-725-2525
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: BEN TYBERG
Title or Position: MANAGER
Credential:
Phone: 718-925-2999