Provider Demographics
NPI:1497417497
Name:BE TRANSFORMED WELLNESS CENTERS PLLC
Entity Type:Organization
Organization Name:BE TRANSFORMED WELLNESS CENTERS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:
Authorized Official - Last Name:BARNARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-578-8993
Mailing Address - Street 1:2609 JENKINTOWN RD
Mailing Address - Street 2:
Mailing Address - City:GLENSIDE
Mailing Address - State:PA
Mailing Address - Zip Code:19038-2501
Mailing Address - Country:US
Mailing Address - Phone:215-659-7345
Mailing Address - Fax:215-780-1221
Practice Address - Street 1:2609 JENKINTOWN RD
Practice Address - Street 2:
Practice Address - City:GLENSIDE
Practice Address - State:PA
Practice Address - Zip Code:19038-2501
Practice Address - Country:US
Practice Address - Phone:215-659-7345
Practice Address - Fax:215-780-1221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-07
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016707370005Medicaid
PA1037448790001Medicaid