Provider Demographics
NPI:1609828656
Name:COLONIAL EMERGENCY PHYSICIANS
Entity Type:Organization
Organization Name:COLONIAL EMERGENCY PHYSICIANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:JERRY
Authorized Official - Last Name:SALOMONE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-361-4440
Mailing Address - Street 1:100 WITMER RD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:HORSHAM
Mailing Address - State:PA
Mailing Address - Zip Code:19044-2211
Mailing Address - Country:US
Mailing Address - Phone:215-442-5051
Mailing Address - Fax:215-957-2875
Practice Address - Street 1:100 MEDICAL CAMPUS DR
Practice Address - Street 2:
Practice Address - City:LANSDALE
Practice Address - State:PA
Practice Address - Zip Code:19446-1259
Practice Address - Country:US
Practice Address - Phone:215-361-4440
Practice Address - Fax:215-361-4864
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA264384OtherBLUE SHIELD
PA0017042270003Medicaid
PA0017042270003Medicaid
PA0017042270003Medicaid
PA007277Medicare PIN