Provider Demographics
NPI:1164403358
Name:ABINGTON MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:ABINGTON MEMORIAL HOSPITAL
Other - Org Name:JEFFERSON HEALTH HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:MERLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-481-5837
Mailing Address - Street 1:2510 MARYLAND RD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:WILLOW GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:19090-1109
Mailing Address - Country:US
Mailing Address - Phone:215-481-5800
Mailing Address - Fax:215-481-5850
Practice Address - Street 1:2510 MARYLAND RD
Practice Address - Street 2:SUITE 250
Practice Address - City:WILLOW GROVE
Practice Address - State:PA
Practice Address - Zip Code:19090-1109
Practice Address - Country:US
Practice Address - Phone:215-481-5800
Practice Address - Fax:215-481-5850
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ABINGTON MEMORIAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-11-07
Last Update Date:2016-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA714505251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007691860199Medicaid
PA397145Medicare Oscar/Certification