Provider Demographics
NPI:1043963150
Name:HARVEST MEDICAL FAMILY PRACTICE P.C.
Entity Type:Organization
Organization Name:HARVEST MEDICAL FAMILY PRACTICE P.C.
Other - Org Name:HARVEST MEDICAL FAMILY PRACTICE P.C.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DR. SADE
Authorized Official - Middle Name:
Authorized Official - Last Name:ADEOJO
Authorized Official - Suffix:
Authorized Official - Credentials:DNP-FNP-BC
Authorized Official - Phone:610-750-0526
Mailing Address - Street 1:2211 QUARRY DR STE E58C
Mailing Address - Street 2:
Mailing Address - City:WEST LAWN
Mailing Address - State:PA
Mailing Address - Zip Code:19609-1170
Mailing Address - Country:US
Mailing Address - Phone:484-861-2868
Mailing Address - Fax:484-861-3262
Practice Address - Street 1:2211 QUARRY DR STE E58C
Practice Address - Street 2:
Practice Address - City:WEST LAWN
Practice Address - State:PA
Practice Address - Zip Code:19609-1170
Practice Address - Country:US
Practice Address - Phone:484-861-2868
Practice Address - Fax:484-861-3262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-28
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care