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NPI Code Detail

MEDICARE: OAK LANEMEDICAL CENTER

MEDICARE: OAK LANEMEDICAL CENTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QH0100XHealth Service Clinic/Center

General Provider Information

NPI Number : 1528221488
Entity Type Code : Organization
Provider Name (Legal Business Name) : OAK LANEMEDICAL CENTER
Provider Business Mailing Address
First Line : 6715 OLD YORK RD
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19126-2841
Country : US
Telephone Number : 215-927-3778
Fax Number : 215-927-3745
Provider Business Practice Location Address
First Line : 6715 OLD YORK RD
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19126-2841
Country : US
Telephone Number : 215-927-3778
Fax Number : 215-927-3745
Authorized Official
Title or Position : CEO
Name : MR. GERARD ROLAND
Credential :
Telephone Number : 215-927-3778
Provider Enumeration Date : 07/09/2008
Last Update Date : 07/09/2008

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Directions to “OAK LANEMEDICAL CENTER ” Practice Location

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