Provider Demographics
NPI:1710978226
Name:FOX SUBACUTE AT CLARA BURKE
Entity Type:Organization
Organization Name:FOX SUBACUTE AT CLARA BURKE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOE
Authorized Official - Middle Name:
Authorized Official - Last Name:MURRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-343-2700
Mailing Address - Street 1:251 STENTON AVE
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH MEETING
Mailing Address - State:PA
Mailing Address - Zip Code:19462-1220
Mailing Address - Country:US
Mailing Address - Phone:610-828-2272
Mailing Address - Fax:610-862-0614
Practice Address - Street 1:251 STENTON AVE
Practice Address - Street 2:
Practice Address - City:PLYMOUTH MEETING
Practice Address - State:PA
Practice Address - Zip Code:19462-1220
Practice Address - Country:US
Practice Address - Phone:610-828-2272
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA036302313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2590550OtherAETNA
PA0006262000OtherBLUE CROSS
PA0018745120001Medicaid
PA0006262000OtherKEYSTONE
PA0018745120001Medicaid