Provider Demographics
NPI:1235136904
Name:HOUSE CALL GROUP, PC
Entity Type:Organization
Organization Name:HOUSE CALL GROUP, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:M.
Authorized Official - Middle Name:JASON
Authorized Official - Last Name:GOFT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-233-9842
Mailing Address - Street 1:PO BOX 584
Mailing Address - Street 2:
Mailing Address - City:FLOURTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19031-0584
Mailing Address - Country:US
Mailing Address - Phone:215-233-9842
Mailing Address - Fax:215-233-9488
Practice Address - Street 1:1110 BETHLEHEM PIKE
Practice Address - Street 2:
Practice Address - City:FLOURTOWN
Practice Address - State:PA
Practice Address - Zip Code:19031-2001
Practice Address - Country:US
Practice Address - Phone:215-233-9842
Practice Address - Fax:215-233-9488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD026111E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PACH9541OtherRAILROAD RETIREMENT MEDIC
PA0820789001OtherKEYSTONE
PA0820789000OtherKEYSTONE
PA0820789000OtherKEYSTONE