Provider Demographics
NPI:1326146226
Name:MAIN LINE HAND CENTER LLC
Entity Type:Organization
Organization Name:MAIN LINE HAND CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROBERTA
Authorized Official - Middle Name:F
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:OTRL CHR
Authorized Official - Phone:610-651-8282
Mailing Address - Street 1:250 W LANCASTER AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:PAOLI
Mailing Address - State:PA
Mailing Address - Zip Code:19301-1743
Mailing Address - Country:US
Mailing Address - Phone:610-651-8282
Mailing Address - Fax:610-651-8213
Practice Address - Street 1:250 W LANCASTER AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:PAOLI
Practice Address - State:PA
Practice Address - Zip Code:19301-1743
Practice Address - Country:US
Practice Address - Phone:610-651-8282
Practice Address - Fax:610-651-8213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2008-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Multi-Specialty
No2251H1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistHandGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
3207843OtherAETNA PPO
2116515000OtherPERSONAL CHOICE ROBERTA M
2116418000OtherKEYSTONE HPE KEYSTONE 65
0401979000OtherPERSONAL CHOICE 65 TERI S
P00122385OtherMEDICARE RAILROAD
2627004000OtherPERSONAL CHOICE 65 KATHY
=========OtherPRIVATE HEALTHCARE SYSTEM
=========OtherSMART COMP
2116418000OtherKEYSTONE HPE KEYSTONE 65
2627004000OtherPERSONAL CHOICE 65 KATHY
=========OtherDEVON HEALTH SYSTEMS
2116515000OtherPERSONAL CHOICE ROBERTA M
=========OtherDEVON HEALTH SYSTEMS
2116418000OtherKEYSTONE HPE KEYSTONE 65
=========OtherFIRST HEALTH
2627004000OtherPERSONAL CHOICE 65 KATHY
087898QZYMedicare ID - Type UnspecifiedKATHY POPIEL
=========OtherSMART COMP
062897QZYMedicare ID - Type UnspecifiedTERI SPEAKMAN
062907QZYMedicare ID - Type UnspecifiedROBERTA MORRIS