Provider Demographics
NPI:1215197942
Name:CROZER CHESTER MEDICAL CENTER
Entity Type:Organization
Organization Name:CROZER CHESTER MEDICAL CENTER
Other - Org Name:FAMILY PLANNING
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DRU
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMMELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-447-2271
Mailing Address - Street 1:ONE MEDICAL CENTER BOULEVARD
Mailing Address - Street 2:PEARL HALL
Mailing Address - City:UPLAND
Mailing Address - State:PA
Mailing Address - Zip Code:19013-0000
Mailing Address - Country:US
Mailing Address - Phone:610-447-2271
Mailing Address - Fax:610-447-2215
Practice Address - Street 1:ONE MEDICAL CENTER BOULEVARD
Practice Address - Street 2:PEARL HALL
Practice Address - City:UPLAND
Practice Address - State:PA
Practice Address - Zip Code:19013-0000
Practice Address - Country:US
Practice Address - Phone:610-447-2271
Practice Address - Fax:610-447-2215
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CROZER TAYLOR SPRINGFIELD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-06-16
Last Update Date:2013-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA037201261QF0050X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0050XAmbulatory Health Care FacilitiesClinic/CenterFamily Planning, Non-Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007605830044OtherKEYSTONE MERCY HEALTH PLAN
PA0073794903OtherAMERICHOICE
PA1007605830044Medicaid