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General NPI Number Information
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NPI Number | 1710978226
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Entity Type | Organization
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Legal Business Name | FOX SUBACUTE AT CLARA BURKE
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Dates
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Enumeration Date | 11/03/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 251 STENTON AVE
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City | PLYMOUTH MEETING
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State | PA
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Zip | 19462-1220
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Country | US
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Telephone | 610-828-2272
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Fax |
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Provider Business Mailing Address
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Address Line | 251 STENTON AVE
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City | PLYMOUTH MEETING
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State | PA
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Zip | 19462-1220
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Country | US
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Telephone | 610-828-2272
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Fax | 610-862-0614
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. JOE MURRAY
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Credential |
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Telephone | 215-343-2700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | 036302
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License Number State | PA
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