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NPI Code Detail

MEDICARE: PATHWAYS PA

MEDICARE: PATHWAYS PA
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
1251B00000XCase Management Agency122820PA

General Provider Information

NPI Number : 1578729489
Entity Type Code : Organization
Provider Name (Legal Business Name) : PATHWAYS PA
Provider Business Mailing Address
First Line : 310 AMOSLAND RD
Second Line :
City : HOLMES
State : PA
Zip : 19043-1216
Country : US
Telephone Number : 610-543-5022
Fax Number : 610-543-1549
Provider Business Practice Location Address
First Line : 3617 LANCASTER AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19104-2603
Country : US
Telephone Number : 215-387-1470
Fax Number : 215-222-3720
Authorized Official
Title or Position : VICE PRESIDENT RESIDENTIAL SERVICES
Name : MS. JOAN M HALDEMAN
Credential : LSW
Telephone Number : 610-543-5022
Provider Enumeration Date : 07/30/2008
Last Update Date : 07/30/2008

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Directions to “PATHWAYS PA ” Practice Location

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