Provider Demographics
NPI:1568498137
Name:NORTH SCHUYLKILL EMERGENCY PHYSICIANS LLC
Entity Type:Organization
Organization Name:NORTH SCHUYLKILL EMERGENCY PHYSICIANS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ROSS
Authorized Official - Middle Name:
Authorized Official - Last Name:RONAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-401-2386
Mailing Address - Street 1:13737 NOEL RD
Mailing Address - Street 2:STE 1600
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240-1331
Mailing Address - Country:US
Mailing Address - Phone:469-401-2386
Mailing Address - Fax:
Practice Address - Street 1:101 BROAD ST
Practice Address - Street 2:EMERGENCY DEPARTMENT
Practice Address - City:ASHLAND
Practice Address - State:PA
Practice Address - Zip Code:17921-2147
Practice Address - Country:US
Practice Address - Phone:469-401-2386
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-24
Last Update Date:2015-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA50024532OtherBLUE CROSS
PA1511241OtherBLUE SHIELD
PA0019693110001Medicaid
PA=========OtherCHAMPUS
PA086292Medicare ID - Type Unspecified