Healthcare Provider Details

I. General information

NPI: 1912247537
Provider Name (Legal Business Name): LANSDALE HOSPITAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2013
Last Update Date: 02/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

228 RIDGE AVE
SOUDERTON PA
18964-1442
US

IV. Provider business mailing address

228 RIDGE AVE
SOUDERTON PA
18964-1442
US

V. Phone/Fax

Practice location:
  • Phone: 215-703-0523
  • Fax: 215-703-8931
Mailing address:
  • Phone: 215-703-0523
  • Fax: 215-703-8931

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. LARRY MERLIS
Title or Position: PRESIDENT/CEO
Credential:
Phone: 215-481-5837