Community Health and Dental Care, Inc

Organization Active NPI Federally Qualified Health Center (FQHC) · Pottstown, PA

NPI 1295994341 · NPPES record last updated Feb 15, 2019

Key facts

NPI
1295994341
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
License
3293340 (PA)
Legal business name
COMMUNITY HEALTH AND DENTAL CARE, INC
Practice address
351 W Schuylkill Rd Ste G-15a
Pottstown, PA 19465-7438
Phone
(610) 326-9460
Fax
(610) 222-5006
NPI assigned
Jun 4, 2008
Organization subpart
No

Authorized official

Name
Bridget McGivern
Title
Chief Executive Officer
Phone
(610) 326-9460

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Practitioners 71

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 71

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in PA

Federally qualified health center certification: CCN 391040

Legal name
COMMUNITY HEALTH AND DENTAL CARE INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 23, 2014
Last certification
Apr 23, 2014
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Mar 23, 2005 in PA
Enrollment address
700 Heritage Dr
Ste 701
Pottstown, PA 19464-3297

All disclosed owners & managing parties 6

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Ruth Cole
Individual
Corporate Director
Board Secretary
Dec 8, 2023
Jack Burns
Individual
Corporate Director
Board Treasurer
Dec 8, 2023
Frank Buttaro
Individual
Corporate Director
Board Vice President
Dec 8, 2023
Irene Shepherd
Individual
W-2 Managing Employee
Chief Medical Officer
Apr 9, 2018 50%
Marta Pecharo
Individual
Corporate Director
Board President
Dec 8, 2023
Bridget McGivern
Individual
W-2 Managing Employee
Chief Executive Officer
Sep 7, 2010

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20081112000554 PA Part B Supplier - Clinic/Group Practice 5395804827 Receives reassigned benefits from 68 practitioners
1 other NPI on this enrollment
Practice locations: Barto, PA; Boyertown, PA; Pottstown, PA
O20140416001126 PA Part a Provider - Federally Qualified Health Center (FQHC) 5395804827 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Pottstown, PA

National Provider Directory

Locations

6 E Philadelphia Ave
Boyertown, PA 19512
Phone (610) 369-0606

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X 3293340 PA
Federally Qualified Health Center (FQHC) 261QF0400X 3293340 PA Yes

Addresses

Primary practice location

351 W Schuylkill Rd Ste G-15a
Pottstown, PA 19465-7438

Mailing address

351 W Schuylkill Rd Ste G-15a
Pottstown, PA 19465-7438
Phone (610) 326-9460

Other names

  • Pottstown Area Health Center, Inc Former legal business name

Other providers in Pottstown, PA

All providers in Pottstown, PA · Federally Qualified Health Center (FQHC) in Pennsylvania

Sources for this page

Verify at the official NPI Registry.