Healthcare Provider Details

I. General information

NPI: 1871145383
Provider Name (Legal Business Name): R-HEALTH PRIMARY CARE MEDICAL HOME PA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2019
Last Update Date: 07/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 OXFORD VALLEY RD STE 1501
YARDLEY PA
19067-7706
US

IV. Provider business mailing address

210 YORKTOWN PLZ
ELKINS PARK PA
19027-1424
US

V. Phone/Fax

Practice location:
  • Phone: 215-826-3022
  • Fax: 267-399-3996
Mailing address:
  • Phone: 215-600-4590
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: NANCY MEISINGER
Title or Position: CHIEF CLINICAL & OPERATIONS OFFICER
Credential:
Phone: 215-600-4593