Provider Demographics
NPI:1568498830
Name:BUTTONWOOD FARMS, INC.
Entity Type:Organization
Organization Name:BUTTONWOOD FARMS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:MR
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:M
Authorized Official - Last Name:STEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-637-8235
Mailing Address - Street 1:3380 BYBERRY RD
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19154-2909
Mailing Address - Country:US
Mailing Address - Phone:215-637-8235
Mailing Address - Fax:215-612-0469
Practice Address - Street 1:3380 BYBERRY RD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19154-2909
Practice Address - Country:US
Practice Address - Phone:215-637-8235
Practice Address - Fax:215-612-0469
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-25
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017732600003Medicaid