Provider Demographics
NPI:1144218520
Name:MONTGOMERY COUNTY TREAS COURT HOUSE
Entity Type:Organization
Organization Name:MONTGOMERY COUNTY TREAS COURT HOUSE
Other - Org Name:PARKHOUSE PROVIDENCE POINTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:LOU
Authorized Official - Last Name:MORRISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-792-2224
Mailing Address - Street 1:1600 BLACK ROCK RD
Mailing Address - Street 2:
Mailing Address - City:ROYERSFORD
Mailing Address - State:PA
Mailing Address - Zip Code:19468-3109
Mailing Address - Country:US
Mailing Address - Phone:610-792-4026
Mailing Address - Fax:
Practice Address - Street 1:1600 BLACK ROCK RD
Practice Address - Street 2:
Practice Address - City:ROYERSFORD
Practice Address - State:PA
Practice Address - Zip Code:19468-3109
Practice Address - Country:US
Practice Address - Phone:610-792-4026
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-11
Last Update Date:2014-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA133402314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0007477580001Medicaid
PA098416OtherGROUP NUMBER
1275596942OtherNPI
PA1457653404OtherNPI
PA098438OtherGROUP NUMBER
PA1114195336OtherNPI
PA1194769596OtherNPI
PA1590117Medicaid
PA178087OtherGROUP NUMBER
PA192127PAAOtherPTAN
PA785606GGMOtherPTAN
PAMD205057EOtherLICENSE
PA1558325340OtherNPI
PA177908OtherGROUP NUMBER
PA1962412791OtherNPI
PA1114195336OtherT88985
PA1275596942OtherNPI
PA1952389454OtherNPI
PA098439OtherGROUP NUMBER
PA178124OtherGROUP NUMBER
PA098450OtherGROUP
PA1114195336OtherOEG001021
PA1588631337OtherNPI
PA602031GGQOtherPTAN
PA192127PAAOtherPTAN
PAT88982Medicare UPIN
PAC333285Medicare UPIN
PA0350940001Medicare NSC
PA019537FBUMedicare PIN
PA786895GGMMedicare PIN
PA1194769596OtherNPI
PA395454Medicare Oscar/Certification
PA1588631337OtherNPI
PA098439OtherGROUP NUMBER
1275596942OtherNPI
PA1114195336OtherOEG001021
PAF69841Medicare UPIN
PAB33396Medicare UPIN
PAT92713Medicare UPIN
PAI15630Medicare UPIN
PA082864GGMMedicare PIN
PA098416OtherGROUP NUMBER
PA602031GGQOtherPTAN
PA1558325340OtherNPI
PA1962412791OtherNPI
PA1952389454OtherNPI
PAB35542Medicare UPIN
PA0007477580001Medicaid
PALA868066Medicare PIN
PA192127PAAMedicare PIN