Provider Demographics
NPI:1407873300
Name:FRANKLIN COMMUNITY HEALTH CARE ASSOCIATES PC
Entity Type:Organization
Organization Name:FRANKLIN COMMUNITY HEALTH CARE ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:M
Authorized Official - Last Name:JANSEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:814-437-5776
Mailing Address - Street 1:1266 LIBERTY STREET
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:PA
Mailing Address - Zip Code:16323
Mailing Address - Country:US
Mailing Address - Phone:814-437-5776
Mailing Address - Fax:814-437-5304
Practice Address - Street 1:1266 LIBERTY STREET
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:PA
Practice Address - Zip Code:16323
Practice Address - Country:US
Practice Address - Phone:814-437-5776
Practice Address - Fax:814-437-5304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2010-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD044671L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAF18677Medicare UPIN
PA88833Medicare ID - Type Unspecified