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NPI Code Detail

MEDICARE: AHF- MONTGOMERY INC

MEDICARE: AHF- MONTGOMERY INC
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
1314000000XSkilled Nursing Facility032202PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1598749558
Entity Type Code : Organization
Provider Name (Legal Business Name) : AHF- MONTGOMERY INC
Provider Business Mailing Address
First Line : 5920 VENTURE DR STE 100
Second Line :
City : DUBLIN
State : OH
Zip : 43017-2236
Country : US
Telephone Number : 614-760-7352
Fax Number : 614-760-7356
Provider Business Practice Location Address
First Line : 600 W CHELTENHAM AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19126-3045
Country : US
Telephone Number : 215-927-7300
Fax Number : 215-224-0850
Authorized Official
Title or Position : PRESIDENT
Name : MR. MARK T HAEMMERLE
Credential : CPA, INACTIVE
Telephone Number : 614-760-7352
Provider Enumeration Date : 12/02/2005
Last Update Date : 03/09/2020

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