Provider Demographics
NPI:1255318085
Name:DIGESTIVE HEALTHCARE CENTER PA
Entity Type:Organization
Organization Name:DIGESTIVE HEALTHCARE CENTER PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KUANDIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:JACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-218-9222
Mailing Address - Street 1:511 COURTYARD DR
Mailing Address - Street 2:BUILDING 500
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NJ
Mailing Address - Zip Code:08844-4255
Mailing Address - Country:US
Mailing Address - Phone:908-218-9222
Mailing Address - Fax:908-218-9818
Practice Address - Street 1:511 COURTYARD DR
Practice Address - Street 2:BUILDING 500
Practice Address - City:HILLSBOROUGH
Practice Address - State:NJ
Practice Address - Zip Code:08844-4255
Practice Address - Country:US
Practice Address - Phone:908-218-9222
Practice Address - Fax:908-218-9818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-22
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty