Healthcare Provider Details

I. General information

NPI: 1376054643
Provider Name (Legal Business Name): BERKS ENCORE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2017
Last Update Date: 10/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 N 9TH ST
READING PA
19601-3657
US

IV. Provider business mailing address

40 N 9TH ST
READING PA
19601-3657
US

V. Phone/Fax

Practice location:
  • Phone: 610-374-3195
  • Fax:
Mailing address:
  • Phone: 610-374-3195
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number StateNULL

VIII. Authorized Official

Name: LUANN OATMAN
Title or Position: PRESIDENT & CEO
Credential:
Phone: 610-374-3195