Provider Demographics
NPI:1376552794
Name:CARPENTER FAMILY CHIROPRACTIC PC
Entity Type:Organization
Organization Name:CARPENTER FAMILY CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:A
Authorized Official - Last Name:CARPENTER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:215-529-6077
Mailing Address - Street 1:PO BOX 216
Mailing Address - Street 2:263 E BROAD STREET
Mailing Address - City:TRUMBAUERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18970
Mailing Address - Country:US
Mailing Address - Phone:215-529-6077
Mailing Address - Fax:215-529-6078
Practice Address - Street 1:263 E BROAD STREET
Practice Address - Street 2:
Practice Address - City:TRUMBAUERSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18970
Practice Address - Country:US
Practice Address - Phone:215-529-6077
Practice Address - Fax:215-529-6078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC5765L111N00000X
PADC009377L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SNI1768247OtherHMBC DR SNYDER
CA80038OtherHMBC DR CARPENTER
PPO3976961OtherAETNA DR SNYDER
2450383000OtherKPHE DR SNYDER
0824035000OtherKEYSTONE DR CARPENTER
1768247OtherPC DR SNYDER
HMO3100440OtherAETNA DR CARPENTER
PPO7457268OtherAETNA DR CARPENTER
HMO7526710OtherAETNA DR SNYDER
CA1579486OtherBCBS DR CARPENTER
0824035000OtherKEYSTONE DR CARPENTER
U57940Medicare UPIN
093789Medicare ID - Type UnspecifiedDR SNYDER
1768247OtherPC DR SNYDER