NPIMap

Organization Active NPI

Penncare-Pennsylvania Hospitalist Associates

  • Non-Pharmacy Dispensing Site
  • Kennett Square, PA
National Provider Identifier
1184766321
Registry record updated Oct 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
License
OS007049E Issued in PA
Legal business name
PENNCARE-PENNSYLVANIA HOSPITALIST ASSOCIATES
Practice address
402 McFarlan Rd
102
Kennett Square, PA 19348-2453
Phone
(610) 444-5678
NPI assigned
Feb 13, 2007
Organization subpart
Yes
Parent organization
MEDVANTX, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 17, 2012

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

Authorized official

Name
Kenny Heine
Title
Director of Operations
Phone
(858) 625-2990

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X OS007049E PA Primary

Addresses

Primary practice location

402 McFarlan Rd
102
Kennett Square, PA 19348-2453

Mailing address

5626 Oberlin Dr
Suite 110
San Diego, CA 92121-1705

National Provider Directory

National Provider Directory
Tax ID family
Penncare-Pennsylvania Hospitalist Associates13 organizations share this tax ID, including this one
Part of
Tri - State Medical Group Inc

Other organizations with this tax ID 12

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": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350432000000",
    "number": "1184766321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5626 OBERLIN DR",
            "address_2": "SUITE 110",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 MCFARLAN RD",
            "address_2": "102",
            "city": "KENNETT SQUARE",
            "state": "PA",
            "postal_code": "193482453",
            "telephone_number": "610-444-5678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENNCARE-PENNSYLVANIA HOSPITALIST ASSOCIATES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDVANTX, INC",
        "enumeration_date": "2007-02-13",
        "last_updated": "2012-10-17",
        "status": "A",
        "authorized_official_last_name": "HEINE",
        "authorized_official_first_name": "KENNY",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "858-625-2990"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "PA",
            "license": "OS007049E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennett Square, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2012; 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.