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General NPI Number Information
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NPI Number | 1225995152
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Entity Type | Organization
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Legal Business Name | 800 BECKS KNOB ROAD OPCO LLC
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Dates
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Enumeration Date | 01/05/2026
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Last Update Date | 01/05/2026
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Provider Practice Location Address
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Address Line | 800 BECKS KNOB RD
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City | LANCASTER
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State | OH
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Zip | 43130-8802
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Country | US
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Telephone | 856-282-5590
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Fax |
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Provider Business Mailing Address
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Address Line | 5 EVES DR
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City | MARLTON
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State | NJ
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Zip | 08053-3135
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | VP COMPLIANCE
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Name | JENNIFER MELLON
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Credential |
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Telephone | 856-282-5590
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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