Provider Demographics
NPI:1700848280
Name:WEST READING RADIOLOGY ASSOCIATES
Entity Type:Organization
Organization Name:WEST READING RADIOLOGY ASSOCIATES
Other - Org Name:WRRA
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATIVE COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:M
Authorized Official - Last Name:DEBOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-628-4580
Mailing Address - Street 1:301 S 7TH AVE
Mailing Address - Street 2:STE. 135
Mailing Address - City:WEST READING
Mailing Address - State:PA
Mailing Address - Zip Code:19611-1410
Mailing Address - Country:US
Mailing Address - Phone:484-628-4580
Mailing Address - Fax:610-736-0721
Practice Address - Street 1:301 S 7TH AVE
Practice Address - Street 2:STE. 135
Practice Address - City:WEST READING
Practice Address - State:PA
Practice Address - Zip Code:19611-1410
Practice Address - Country:US
Practice Address - Phone:484-628-4580
Practice Address - Fax:610-736-0721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-03
Last Update Date:2016-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0006879360011Medicaid
PAWE178254OtherMEDICARE