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General NPI Number Information
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NPI Number | 1801315742
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Entity Type | Organization
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Legal Business Name | R-HEALTH PRIMARY CARE MEDICAL HOME LLC
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Dates
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Enumeration Date | 09/12/2017
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Last Update Date | 08/19/2019
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Provider Practice Location Address
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Address Line | 205 EASTON AVE STE 2
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City | NEW BRUNSWICK
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State | NJ
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Zip | 08901-4410
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Country | US
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Telephone | 215-600-4590
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Fax |
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Provider Business Mailing Address
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Address Line | 210 YORKTOWN PLZ
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City | ELKINS PARK
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State | PA
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Zip | 19027-1424
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Country | US
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Telephone | 215-600-4590
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Fax |
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Authorized Official
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Title or Position | CHIEF CLINICAL & OPERATIONS OFFICER
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Name | NANCY MEISINGER
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Credential |
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Telephone | 215-600-4593
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | MD068622L
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License Number State | PA
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