Healthcare Provider Details
I. General information
NPI: 1982288379
Provider Name (Legal Business Name): ALERE FAMILY HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/11/2021
Last Update Date: 05/11/2021
Certification Date: 05/11/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
334 HARTMAN BRIDGE RD
RONKS PA
17572-9508
US
IV. Provider business mailing address
334 HARTMAN BRIDGE RD
RONKS PA
17572-9508
US
V. Phone/Fax
- Phone: 717-925-8469
- Fax: 717-983-4722
- Phone: 717-925-8469
- Fax: 717-983-4722
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
CHRIS
LUPOLD
Title or Position: OWNER
Credential: MD
Phone: 717-925-8469