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General NPI Number Information
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NPI Number | 1528221488
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Entity Type | Organization
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Legal Business Name | OAK LANEMEDICAL CENTER
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Dates
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Enumeration Date | 07/09/2008
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Last Update Date | 07/09/2008
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Provider Practice Location Address
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Address Line | 6715 OLD YORK RD
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City | PHILADELPHIA
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State | PA
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Zip | 19126-2841
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Country | US
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Telephone | 215-927-3778
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Fax | 215-927-3745
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Provider Business Mailing Address
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Address Line | 6715 OLD YORK RD
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City | PHILADELPHIA
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State | PA
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Zip | 19126-2841
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Country | US
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Telephone | 215-927-3778
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Fax | 215-927-3745
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Authorized Official
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Title or Position | CEO
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Name | MR. GERARD ROLAND
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Credential |
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Telephone | 215-927-3778
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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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