Provider Demographics
NPI:1417903097
Name:BORNEMANN HEALTH CORPORATION
Entity Type:Organization
Organization Name:BORNEMANN HEALTH CORPORATION
Other - Org Name:BORNEMANN CARDIO THORACIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP FINANCE CFO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
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:610-378-2731
Mailing Address - Fax:610-208-8875
Practice Address - Street 1:2494 BERNVILLE RD.
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19605
Practice Address - Country:US
Practice Address - Phone:610-378-2676
Practice Address - Fax:610-378-2679
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2009-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007411020007Medicaid
B01451327OtherHIGHMARK
3052060OtherAETNA
B01451327OtherHIGHMARK