Provider Demographics
NPI:1467510560
Name:EAGLEVILLE HOSPITAL
Entity Type:Organization
Organization Name:EAGLEVILLE HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGLONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-291-2210
Mailing Address - Street 1:100 EAGLEVILLE RD
Mailing Address - Street 2:
Mailing Address - City:EAGLEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19403-1829
Mailing Address - Country:US
Mailing Address - Phone:610-539-6000
Mailing Address - Fax:610-539-6249
Practice Address - Street 1:100 EAGLEVILLE RD
Practice Address - Street 2:
Practice Address - City:EAGLEVILLE
Practice Address - State:PA
Practice Address - Zip Code:19403-1829
Practice Address - Country:US
Practice Address - Phone:610-539-6000
Practice Address - Fax:610-539-6249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA051001276400000X, 282N00000X, 284300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes276400000XHospital UnitsRehabilitation, Substance Use Disorder Unit
No282N00000XHospitalsGeneral Acute Care Hospital
No284300000XHospitalsSpecial Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007779290003Medicaid
PA106359OtherCBH
PAEAGL1977OtherCOMPREHENSIVE BEHAV CARE
PA128150OtherMBH OF PA, INC.
PA0001185000OtherINDEPENDENCE BLUE CROSS
PA004418000OtherMAGELLAN BEHAVIORAL HLTH