NPIMap

Organization Active NPI

Penncare French Creek Family Medicine

  • Non-Pharmacy Dispensing Site
  • Phoenixville, PA
National Provider Identifier
1194867903
Registry record updated Jun 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
License
OS016310 Issued in PA
Legal business name
PENNCARE FRENCH CREEK FAMILY MEDICINE
Practice address
824 Main St
307
Phoenixville, PA 19460-4478
Phone
(610) 933-3182
NPI assigned
Feb 12, 2007
Last updated
Jun 23, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
MEDVANTX, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 23, 2016

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X OS016310 PA Primary

Addresses

Primary practice location

824 Main St
307
Phoenixville, PA 19460-4478

Mailing address

9276 Scranton Rd
Suite 100
San Diego, CA 92121-7701

National Provider Directory

National Provider Directory
Tax ID family
Penncare-Pennsylvania Hospitalist Associates13 organizations share this tax ID, including this one
Part of
Medvantx 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": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466640000000",
    "number": "1194867903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9276 SCRANTON RD",
            "address_2": "SUITE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921217701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "824 MAIN ST",
            "address_2": "307",
            "city": "PHOENIXVILLE",
            "state": "PA",
            "postal_code": "194604478",
            "telephone_number": "610-933-3182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENNCARE FRENCH CREEK FAMILY MEDICINE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDVANTX, INC.",
        "enumeration_date": "2007-02-12",
        "last_updated": "2016-06-23",
        "status": "A",
        "authorized_official_last_name": "HEINE",
        "authorized_official_first_name": "KENNY",
        "authorized_official_title_or_position": "VP OF OPERATIONS",
        "authorized_official_telephone_number": "858-625-2990"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "PA",
            "license": "OS016310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenixville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2016; 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.