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NPI Code Detail

MEDICARE: MERAKEY PENNSYLVANIA

MEDICARE: MERAKEY PENNSYLVANIA
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
1251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1700218260
Entity Type Code : Organization
Provider Name (Legal Business Name) : MERAKEY PENNSYLVANIA
Provider Business Mailing Address
First Line : 4251 CRUMS MILL RD
Second Line :
City : HARRISBURG
State : PA
Zip : 17112-2824
Country : US
Telephone Number : 215-836-3131
Fax Number : 215-273-5975
Provider Business Practice Location Address
First Line : 711 COLONIAL DR STE D
Second Line :
City : BATON ROUGE
State : LA
Zip : 70806-6549
Country : US
Telephone Number : 215-836-3131
Fax Number :
Authorized Official
Title or Position : CORP DIRECTOR OF BUS OPS
Name : MR. NORMAN E TILSON JR.
Credential :
Telephone Number : 215-836-3131
Provider Enumeration Date : 08/06/2013
Last Update Date : 08/01/2024

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Directions to “MERAKEY PENNSYLVANIA ” Practice Location

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