Provider Demographics
NPI:1518092477
Name:ARIA HEALTH PHYSICIAN SERVICES
Entity Type:Organization
Organization Name:ARIA HEALTH PHYSICIAN SERVICES
Other - Org Name:MORRELL PARK FAMILY PRACTICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO APS
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:KUMOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-612-4858
Mailing Address - Street 1:PO BOX 825395
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19182-5395
Mailing Address - Country:US
Mailing Address - Phone:215-807-8000
Mailing Address - Fax:215-632-1661
Practice Address - Street 1:10101 ACADEMY RD
Practice Address - Street 2:SUITE 104
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19114-1120
Practice Address - Country:US
Practice Address - Phone:215-632-4000
Practice Address - Fax:215-632-1661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA207Q00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007526250051Medicaid
PA18170OtherHEALTH PARTNERS
PA379767OtherHIGHMARK BLUE SHIELD
PA379767OtherPERSONAL CHOICE
PA015464001OtherKEYSTONE, IBC
PA1007526250041Medicaid
PA179943OtherHIGHMARK BLUE SHIELD
PACC4831OtherRAILROAD MEDICARE
PA1007526250039Medicaid
PA1025866OtherKEYSTONE MERCY
PA18036OtherAETNA
PA1007526250039Medicaid