Healthcare Provider Details

I. General information

NPI: 1447456637
Provider Name (Legal Business Name): WEST GROVE HOSPITAL COMPANY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2007
Last Update Date: 06/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1015 W BALTIMORE PIKE SUITE 1319
WEST GROVE PA
19390-9459
US

IV. Provider business mailing address

1015 W BALTIMORE PIKE SUITE 1319
WEST GROVE PA
19390-9499
US

V. Phone/Fax

Practice location:
  • Phone: 610-869-1000
  • Fax: 610-869-1383
Mailing address:
  • Phone: 610-869-1000
  • Fax: 610-869-1383

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NR1301X
TaxonomyRural Acute Care Hospital
License NumberDN001444
License Number StatePA

VIII. Authorized Official

Name: JODY LYNNE ZWICK
Title or Position: REGISTERED DIETITIAN
Credential: MA, RD, LD
Phone: 610-869-1000