Provider Demographics
NPI:1750473849
Name:UROLOGY HEALTH SPECIALISTS LLC
Entity Type:Organization
Organization Name:UROLOGY HEALTH SPECIALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MELINDA
Authorized Official - Middle Name:J
Authorized Official - Last Name:HALEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-530-0205
Mailing Address - Street 1:PO BOX 1287
Mailing Address - Street 2:
Mailing Address - City:BLUE BELL
Mailing Address - State:PA
Mailing Address - Zip Code:19422
Mailing Address - Country:US
Mailing Address - Phone:484-530-0205
Mailing Address - Fax:484-530-0209
Practice Address - Street 1:2701 HOLME AVE
Practice Address - Street 2:STE 101
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19152
Practice Address - Country:US
Practice Address - Phone:215-335-3535
Practice Address - Fax:215-335-9466
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2008-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
097818Medicare PIN
PA097818Medicare ID - Type Unspecified