Provider Demographics
NPI:1659965689
Name:SPECIALTY MEDICAL CARE SERVICES, LLC
Entity Type:Organization
Organization Name:SPECIALTY MEDICAL CARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:A
Authorized Official - Last Name:CALLAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:AGPCNP-BC
Authorized Official - Phone:866-268-6609
Mailing Address - Street 1:320 EXTON CMNS
Mailing Address - Street 2:
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-2450
Mailing Address - Country:US
Mailing Address - Phone:866-268-6609
Mailing Address - Fax:866-610-4542
Practice Address - Street 1:320 EXTON CMNS
Practice Address - Street 2:
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-2450
Practice Address - Country:US
Practice Address - Phone:866-268-6609
Practice Address - Fax:866-610-4542
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SPECIALTY MEDICAL CARE SERVICES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-02-20
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction MedicineGroup - Multi-Specialty