Provider Demographics
NPI:1700202041
Name:PMA MEDICAL SPECIALISTS ONCOLOGY
Entity Type:Organization
Organization Name:PMA MEDICAL SPECIALISTS ONCOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CLAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-933-8000
Mailing Address - Street 1:542 N LEWIS RD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:LIMERICK
Mailing Address - State:PA
Mailing Address - Zip Code:19468-3521
Mailing Address - Country:US
Mailing Address - Phone:610-933-8000
Mailing Address - Fax:
Practice Address - Street 1:410 W LINFIELD TRAPPE RD
Practice Address - Street 2:
Practice Address - City:LIMERICK
Practice Address - State:PA
Practice Address - Zip Code:19468-4295
Practice Address - Country:US
Practice Address - Phone:610-495-2300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PMA MEDICAL SPECIALISTS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-03-11
Last Update Date:2014-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty