Healthcare Provider Details

I. General information

NPI: 1730848417
Provider Name (Legal Business Name): RADNOR FAMILY PRACTICE, PLLC, DBA IM HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2021
Last Update Date: 01/09/2023
Certification Date: 01/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

372 W LANCASTER AVE FL 1
WAYNE PA
19087-3924
US

IV. Provider business mailing address

372 W LANCASTER AVE FL 1
WAYNE PA
19087-3924
US

V. Phone/Fax

Practice location:
  • Phone: 610-688-8807
  • Fax: 610-688-2970
Mailing address:
  • Phone: 610-688-8807
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: EMILY FISK
Title or Position: MANAGING DIRECTOR
Credential:
Phone: 610-688-8807