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1649341934

NPI Code Detail

MEDICARE: POTTSTOWN CLINIC COMPANY LLC

MEDICARE: POTTSTOWN CLINIC COMPANY LLC

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
1	208000000X	Pediatrics Physician
2	2085N0904X	Nuclear Radiology Physician
3	208VP0000X	Pain Medicine Physician
4	208600000X	Surgery Physician
5	208M00000X	Hospitalist Physician
6	363L00000X	Nurse Practitioner
7	2085R0202X	Diagnostic Radiology Physician
8	207R00000X	Internal Medicine Physician
9	2084N0400X	Neurology Physician
10	2085R0204X	Vascular & Interventional Radiology Physician
11	207P00000X	Emergency Medicine Physician
12	207ZP0101X	Anatomic Pathology Physician
13	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1649341934
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	POTTSTOWN CLINIC COMPANY LLC

Provider Business Mailing Address
First Line	:	PO BOX 13579
Second Line	:
City	:	READING
State	:	PA
Zip	:	19612-3579
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	730 S HANOVER ST
Second Line	:
City	:	POTTSTOWN
State	:	PA
Zip	:	19465-7520
Country	:	US
Telephone Number	:	610-323-6835
Fax Number	:

Authorized Official
Title or Position	:	EVP & CFO
Name	:	BRIAN RAYME
Credential	:
Telephone Number	:	484-628-1324

Provider Enumeration Date	:	11/10/2006
Last Update Date	:	11/06/2025

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Directions to “POTTSTOWN CLINIC COMPANY LLC ” Practice Location

Language	Start Address	Practice Location

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