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General NPI Number Information
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NPI Number | 1083010219
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Entity Type | Organization
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Legal Business Name | ATLANTIC HERRING INPATIENT SERVICES LLC
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Dates
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Enumeration Date | 11/17/2014
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Last Update Date | 12/05/2019
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Provider Practice Location Address
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Address Line | 1710 LAFAYETTE RD
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City | CRAWFORDSVILLE
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State | IN
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Zip | 47933-1033
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Country | US
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Telephone | 973-251-1132
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Fax | 214-712-2444
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Provider Business Mailing Address
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Address Line | PO BOX 38047
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City | PHILADELPHIA
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State | PA
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Zip | 19101-0812
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Country | US
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Telephone | 973-251-1132
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Fax |
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Authorized Official
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Title or Position | OFFICER
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Name | KATHLEEN KONDAS
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Credential |
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Telephone | 973-251-1132
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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