Entelmed, Inc.

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

ENTELMED, INC.

Doing business as

EntelMed

Practice address

400 Indian Run Rd
Glenmoore, PA 19343-1338

Phone

(484) 985-2757

NPI assigned

Jan 29, 2021

Organization subpart

No

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

Authorized official

Name

Bryan D Burklow

Title

Ceo

Phone

(484) 985-2757

Specialties & licenses 1

Addresses

Other names 1

• EntelMed Doing business as

Tax ID family

Entelmed2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Entelmed Inc.

  • Primary Care Nurse Practitioner
  • Glenmoore, PA
  • NPI 1083205413
  NPD tax ID

Locations

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

{
    "created_epoch": "1611878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611878400000",
    "number": "1285225516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9844 RESEARCH DR STE 200",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926184381",
            "telephone_number": "484-985-2757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 INDIAN RUN RD",
            "city": "GLENMOORE",
            "state": "PA",
            "postal_code": "193431338",
            "telephone_number": "484-985-2757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENTELMED, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-29",
        "last_updated": "2021-01-29",
        "certification_date": "2021-01-28",
        "status": "A",
        "authorized_official_last_name": "BURKLOW",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "484-985-2757"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EntelMed",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Karen Dimarco, R.N.
• Patricia A Donoghue, PH.D.
• Susan R Dutton, M.ED., CCC-SLP
• Eagle Chiropractic at Glenmoore
• Entelmed Inc.
• Katelyn Farish
• Shaheen Frigiola
• Emily Gallagher
• Patricia McHugh Giordano, DO
• Glen Moore Fire Company

• Multi-Specialty Clinic/Center in Glenmoore, PA
• Providers in Glenmoore, PA by specialty
• Multi-Specialty Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2021; 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.