NPI Code Details Logo

NPI 1639176183

NPI 1639176183 : BERKS CENTER FOR DIGESTIVE HEALTH, LP : WYOMISSING, PA

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1639176183
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    BERKS CENTER FOR DIGESTIVE HEALTH, LP 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    06/30/2005
-----------------------------------------------------
    Last Update Date     |    10/29/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    1011 REED AVE SUITE 600
-----------------------------------------------------
    City                 |    WYOMISSING
-----------------------------------------------------
    State                |    PA
-----------------------------------------------------
    Zip                  |    19610-3600
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    610-288-3229
-----------------------------------------------------
    Fax                  |    610-288-3336
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    1011 REED AVE STE 600 
-----------------------------------------------------
    City                 |    WYOMISSING
-----------------------------------------------------
    State                |    PA
-----------------------------------------------------
    Zip                  |    19610-2002
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    610-288-3229
-----------------------------------------------------
    Fax                  |    610-288-3336
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    CEO
-----------------------------------------------------
    Name                 |     TRAVIS  REITER 
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    610-816-0545
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    261QA1903X
-----------------------------------------------------
    Taxonomy Name        |    Ambulatory Surgical Clinic/Center
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2025 Data Labs Health. All rights reserved.