Provider Demographics
NPI:1598980021
Name:SACRED HEART HEALTHCARE SYSTEM
Entity Type:Organization
Organization Name:SACRED HEART HEALTHCARE SYSTEM
Other - Org Name:SACRED HEART PEDIATRIC ASSOCIATES - TREXLERTOWN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP FINANCIE
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GOMBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-776-5141
Mailing Address - Street 1:421 W CHEW ST
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18102-3406
Mailing Address - Country:US
Mailing Address - Phone:610-776-5100
Mailing Address - Fax:610-663-3113
Practice Address - Street 1:6083 HAMILTON BLVD
Practice Address - Street 2:
Practice Address - City:WESCOSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18106-9767
Practice Address - Country:US
Practice Address - Phone:610-366-0752
Practice Address - Fax:610-395-9473
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty