Provider Demographics
NPI:1366459414
Name:BORNEMANN HEALTH CORPORATION
Entity Type:Organization
Organization Name:BORNEMANN HEALTH CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP FINANCE & CFO
Authorized Official - Prefix:
Authorized Official - First Name:DAVUD
Authorized Official - Middle Name:
Authorized Official - Last Name:LIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-378-2288
Mailing Address - Street 1:PO BOX 316
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19603-0316
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:222 N 12TH ST
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19604-2963
Practice Address - Country:US
Practice Address - Phone:610-378-2556
Practice Address - Fax:610-378-2559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-02
Last Update Date:2009-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
824035Medicare ID - Type Unspecified