Provider Demographics
NPI:1689048720
Name:INFUSION CENTER OF PENNSYLVANIA LLC
Entity Type:Organization
Organization Name:INFUSION CENTER OF PENNSYLVANIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:EMMA
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-495-6800
Mailing Address - Street 1:649 N LEWIS RD
Mailing Address - Street 2:SUITE 230-B
Mailing Address - City:ROYERSFORD
Mailing Address - State:PA
Mailing Address - Zip Code:19468-1234
Mailing Address - Country:US
Mailing Address - Phone:610-495-6800
Mailing Address - Fax:610-495-1848
Practice Address - Street 1:649 N LEWIS RD
Practice Address - Street 2:SUITE 230-B
Practice Address - City:ROYERSFORD
Practice Address - State:PA
Practice Address - Zip Code:19468-1234
Practice Address - Country:US
Practice Address - Phone:610-495-6800
Practice Address - Fax:610-495-1848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-29
Last Update Date:2017-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103164233-0001Medicaid
PA103164233-0001Medicaid