Provider Demographics
NPI:1629314356
Name:PURPLE FINCH INPATIENT SERVICES, LLC
Entity Type:Organization
Organization Name:PURPLE FINCH INPATIENT SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-251-1132
Mailing Address - Street 1:13737 NOEL RD 1600
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:TX
Mailing Address - Zip Code:19101-0501
Mailing Address - Country:US
Mailing Address - Phone:954-838-2371
Mailing Address - Fax:877-411-4650
Practice Address - Street 1:333 BORTHWICK AVE
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-7128
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:2012-12-28
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty