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General NPI Number Information
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NPI Number | 1497192975
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Entity Type | Organization
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Legal Business Name | EPHRATA CENTER FOR HEART CARE
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Dates
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Enumeration Date | 05/24/2013
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Last Update Date | 05/24/2013
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Provider Practice Location Address
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Address Line | 169 MARTIN AVE STE 179
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City | EPHRATA
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State | PA
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Zip | 17522-1724
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Country | US
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Telephone | 717-721-5868
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Fax |
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Provider Business Mailing Address
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Address Line | 2921 SANTA MARIA DR
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City | GILBERTSVILLE
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State | PA
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Zip | 19525-9321
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Country | US
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Telephone | 610-828-4381
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Fax |
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Authorized Official
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Title or Position | ADULT NURSE PRACTITIONER
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Name | MRS. JENNIFER KIRSTIN NYMARK
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Credential | CRNP
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Telephone | 610-937-5694
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NR1301X
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Taxonomy Name | Rural Acute Care Hospital
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License Number | SP012874
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License Number State | PA
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