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General NPI Number Information
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NPI Number | 1962452805
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Entity Type | Organization
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Legal Business Name | PHOENIXVILLE HOSPITAL COMPANY, LLC
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 824 MAIN ST SUITE 302
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City | PHOENIXVILLE
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State | PA
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Zip | 19460-4478
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Country | US
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Telephone | 610-983-1561
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Fax | 610-983-1569
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Provider Business Mailing Address
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Address Line | 824 MAIN ST SUITE 302
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City | PHOENIXVILLE
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State | PA
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Zip | 19460-4478
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Country | US
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Telephone | 610-983-1561
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Fax | 610-983-1569
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Authorized Official
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Title or Position | SENIOR VP
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Name | GARY NEWSOME
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Credential |
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Telephone | 610-983-1561
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086X0206X
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Taxonomy Name | Surgical Oncology Physician
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License Number |
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License Number State |
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