Provider Demographics
NPI:1437817079
Name:BERKS COMMUNITY HEALTH CENTER
Entity Type:Organization
Organization Name:BERKS COMMUNITY HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:HELEN
Authorized Official - Last Name:KARGBO
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MS
Authorized Official - Phone:484-772-4091
Mailing Address - Street 1:645 PENN ST STE 301
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19601-3527
Mailing Address - Country:US
Mailing Address - Phone:484-772-4091
Mailing Address - Fax:
Practice Address - Street 1:430 N 2ND ST
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19601-2738
Practice Address - Country:US
Practice Address - Phone:610-988-4838
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-01
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102691224-0004Medicaid