Provider Demographics
NPI:1568417418
Name:REDI CARE PHYSICIANS, INC
Entity Type:Organization
Organization Name:REDI CARE PHYSICIANS, INC
Other - Org Name:REDI CARE MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:W
Authorized Official - Last Name:CARUNO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:610-258-5300
Mailing Address - Street 1:2461 NAZARETH RD
Mailing Address - Street 2:25TH ST. SHOPPING CENTER
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18045-2743
Mailing Address - Country:US
Mailing Address - Phone:610-258-5300
Mailing Address - Fax:610-258-5138
Practice Address - Street 1:2461 NAZARETH RD
Practice Address - Street 2:25TH ST. SHOPPING CENTER
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18045-2743
Practice Address - Country:US
Practice Address - Phone:610-258-5300
Practice Address - Fax:610-258-5138
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-22
Last Update Date:2008-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1262662Medicaid
PA693711Medicare ID - Type Unspecified
PA1262662Medicaid