Provider Demographics
NPI:1710085501
Name:TOWER HEALTH MEDICAL GROUP
Entity Type:Organization
Organization Name:TOWER HEALTH MEDICAL GROUP
Other - Org Name:ENDOCRINOLOGY & DIABETES CENTER WYOMISSING PAPER MILL RD THMG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR VP FINANCIAL OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:EHINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-628-1324
Mailing Address - Street 1:PO BOX 13579
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19612-3579
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1991 STATE HILL RD
Practice Address - Street 2:
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-1648
Practice Address - Country:US
Practice Address - Phone:484-628-4270
Practice Address - Fax:484-628-4261
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2021-11-18
Deactivation Date:2007-12-07
Deactivation Code:
Reactivation Date:2008-03-25
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA072790OtherMEDICARE PTAN