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NPI Code Detail

MEDICARE: MERAKEY PARKSIDE RECOVERY

MEDICARE: MERAKEY PARKSIDE RECOVERY
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
1207Q00000XFamily Medicine Physician
2207R00000XInternal Medicine Physician
3251S00000XCommunity/Behavioral Health Agency

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 : 1831313535
Entity Type Code : Organization
Provider Name (Legal Business Name) : MERAKEY PARKSIDE RECOVERY
Provider Business Mailing Address
First Line : 906 BETHLEHEM PIKE
Second Line :
City : ERDENHEIM
State : PA
Zip : 19038-7731
Country : US
Telephone Number : 215-836-3131
Fax Number : 215-273-5975
Provider Business Practice Location Address
First Line : 5000 PARKSIDE AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19131-4714
Country : US
Telephone Number : 215-836-3131
Fax Number : 215-273-5975
Authorized Official
Title or Position : CORP SR. DIRECTOR OF BUSINESS OPS
Name : MR. NORMAN E TILSON JR.
Credential :
Telephone Number : 215-836-3131
Provider Enumeration Date : 04/12/2007
Last Update Date : 10/26/2022

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Practice Location Address:
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1508064668 — DR. RAYMOND SCOTT BOBB D.O.
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Practice Fax:
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Practice Fax:
1467984211 — DR. JOSEPH HART M.D.
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PHILADELPHIA, PA
19131-4714
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1720767437 — SHIRLEY LEWIS
Practice Location Address:
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1790464113 — DALESQUI BERTIER LPN
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Directions to “MERAKEY PARKSIDE RECOVERY ” Practice Location

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