Advanced Lymphedema Therapy Services, LLC

Organization Active NPI Rehabilitation Clinic/Center · Langhorne, PA

NPI 1407066129 · NPPES record last updated Jul 10, 2007

Key facts

NPI
1407066129
Entity type
Organization (NPI type 2)
Primary specialty
Rehabilitation Clinic/Center 261QR0400X
License
OC008082 (PA)
Legal business name
ADVANCED LYMPHEDEMA THERAPY SERVICES, LLC
Practice address
3 Corner Stone Drive
Suite 700
Langhorne, PA 19047
Phone
(215) 750-0501
Fax
(215) 340-1299
NPI assigned
May 23, 2007
Organization subpart
No

Authorized official

Name
Kimberly Anne Koschineg, OTRL
Title
President
Phone
(215) 913-0127

Practitioners 2

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in PA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20090701000511 PA Part B Supplier - Clinic/Group Practice 1153331269 Receives reassigned benefits from 1 practitioner
Practice locations: Langhorne, PA

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X OC008082 PA Yes

Addresses

Primary practice location

3 Corner Stone Drive
Suite 700
Langhorne, PA 19047

Mailing address

603 Ferris LN
Doylestown, PA 18901-5037
Phone (215) 913-0127

Other providers in Langhorne, PA

All providers in Langhorne, PA · Rehabilitation Clinic/Center in Pennsylvania

Sources for this page

Verify at the official NPI Registry.