Provider Demographics
NPI:1154321271
Name:HR PHYSICIANS SERVICES
Entity Type:Organization
Organization Name:HR PHYSICIANS SERVICES
Other - Org Name:WOMEN'S CARE OF MONTGOMERY COUNTY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT, FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:R
Authorized Official - Last Name:WAGNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-856-1114
Mailing Address - Street 1:12265 TOWNSEND ROAD
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19154-1214
Mailing Address - Country:US
Mailing Address - Phone:215-856-1010
Mailing Address - Fax:215-856-1060
Practice Address - Street 1:735 FITZWATERTOWN ROAD
Practice Address - Street 2:SUITE 4
Practice Address - City:WILLOW GROVE
Practice Address - State:PA
Practice Address - Zip Code:19090
Practice Address - Country:US
Practice Address - Phone:215-914-4400
Practice Address - Fax:215-657-4887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001531340030Medicaid
004247Medicare ID - Type Unspecified