Provider Demographics
NPI:1689674558
Name:TOTAL HOSPITAL CARE
Entity Type:Organization
Organization Name:TOTAL HOSPITAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEAD DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAMIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CORNACCHIA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:610-372-6617
Mailing Address - Street 1:11 WOODSVIEW DR
Mailing Address - Street 2:
Mailing Address - City:GARNET VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19061-1227
Mailing Address - Country:US
Mailing Address - Phone:610-372-6617
Mailing Address - Fax:
Practice Address - Street 1:11 WOODSVIEW DR
Practice Address - Street 2:
Practice Address - City:GARNET VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19061-1227
Practice Address - Country:US
Practice Address - Phone:610-372-6617
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0019501500003Medicaid
PA068839Medicare PIN