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General NPI Number Information
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NPI Number | 1659054229
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Entity Type | Organization
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Legal Business Name | PHOENIXVILLE CLINIC COMPANY LLC
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Dates
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Enumeration Date | 08/10/2023
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Last Update Date | 08/10/2023
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Provider Practice Location Address
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Address Line | 420 W LINFIELD TRAPPE RD STE 3100
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City | LIMERICK
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State | PA
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Zip | 19468-4277
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Country | US
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Telephone | 484-628-5673
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 13579
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City | READING
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State | PA
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Zip | 19612-3579
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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 | SR VP FINANCIAL
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Name | ROBERT EHINGER
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Credential |
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Telephone | 484-628-1324
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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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 | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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