Provider Demographics
NPI:1326093014
Name:ABINGTON MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:ABINGTON MEMORIAL HOSPITAL
Other - Org Name:ABINGTON MEMORIAL HOSPITAL HOME INFUSION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LAURENCE
Authorized Official - Middle Name:M
Authorized Official - Last Name:MERLIS
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:215-481-2006
Mailing Address - Street 1:2500 MARYLAND ROAD
Mailing Address - Street 2:SUITE G-30
Mailing Address - City:WILLOW GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:19090-1227
Mailing Address - Country:US
Mailing Address - Phone:215-481-6900
Mailing Address - Fax:215-481-6904
Practice Address - Street 1:2500 MARYLAND ROAD
Practice Address - Street 2:SUITE G-30
Practice Address - City:WILLOW GROVE
Practice Address - State:PA
Practice Address - Zip Code:19090-1227
Practice Address - Country:US
Practice Address - Phone:215-481-6900
Practice Address - Fax:215-481-6904
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ABINGTON MEMORIAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-23
Last Update Date:2012-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP036539251F00000X
251F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251F00000XAgenciesHome Infusion
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2316475OtherAUSHC
PA0004116000OtherIBX
PA2091749OtherUNITED HEALTHCARE
PA0004116000OtherIBX