Active NPI
Certified Healthcare Professionals
- Clinical Medical Laboratory
- Havertown, PA
National Provider Identifier
1912912379
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- Legal business name
- CERTIFIED HEALTHCARE PROFESSIONALS
- Practice address
- 1729 Josie LN
Havertown, PA 19083-1218 - Phone
- (610) 955-7421
- Fax
- (866) 446-8819
- NPI assigned
- Jul 31, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Christyne C Price, MHA
- Title
- Pres/Ceo
- Phone
- (610) 955-7421
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | Primary |
Addresses
Primary practice location
1729 Josie LN
Havertown, PA 19083-1218
Mailing address
PO Box 30
Ardmore, PA 19003
Phone (610) 955-7421
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1018507830001 | Medicaid | PA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070403000625 | PA | Part B Supplier - Independent Clinical Laboratory | 8628172475 | Practice locations: Broomall, PA |
National Provider Directory
National Provider DirectoryLocations
571 Abbott Dr
Broomall, PA 19008
Phone (484) 479-3991
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154304000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1367971200000",
"number": "1912912379",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 30",
"city": "ARDMORE",
"state": "PA",
"postal_code": "19003",
"telephone_number": "610-955-7421",
"fax_number": "866-446-8819"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1729 JOSIE LN",
"city": "HAVERTOWN",
"state": "PA",
"postal_code": "190831218",
"telephone_number": "610-955-7421",
"fax_number": "866-446-8819"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CERTIFIED HEALTHCARE PROFESSIONALS",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-31",
"last_updated": "2013-05-08",
"status": "A",
"authorized_official_last_name": "PRICE",
"authorized_official_first_name": "CHRISTYNE",
"authorized_official_middle_name": "C",
"authorized_official_title_or_position": "PRES/CEO",
"authorized_official_telephone_number": "610-955-7421",
"authorized_official_credential": "MHA"
},
"taxonomies": [
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1018507830001",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Havertown, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.