NPIMap

Organization Active NPI

Bethanna

  • Community/Behavioral Health Agency
  • Southampton, PA
National Provider Identifier
1114143823
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
100910 Issued in PA
Legal business name
BETHANNA
Practice address
1030 2ND Street Pike
Southampton, PA 18966-3955
Phone
(215) 355-6500
Fax
(215) 355-8617
NPI assigned
Apr 18, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Ronald L Fritch
Title
Chief Financial Officer
Phone
(215) 355-6500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 100910 PA Primary

Addresses

Primary practice location

1030 2ND Street Pike
Southampton, PA 18966-3955

Mailing address

1030 2ND Street Pike
Southampton, PA 18966-3955
Phone (215) 355-6500

Other identifiers 1

IdentifierTypeStateIssuer
1007513410001MedicaidPA

Other names 1

  • Bethanna Bible and Missionary Center Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Bethanna7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114143823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 2ND STREET PIKE",
            "city": "SOUTHAMPTON",
            "state": "PA",
            "postal_code": "189663955",
            "telephone_number": "215-355-6500",
            "fax_number": "215-355-8617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 2ND STREET PIKE",
            "city": "SOUTHAMPTON",
            "state": "PA",
            "postal_code": "189663955",
            "telephone_number": "215-355-6500",
            "fax_number": "215-355-8617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETHANNA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FRITCH",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "215-355-6500",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "PA",
            "license": "100910",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007513410001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bethanna Bible and Missionary Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Southampton, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.