Provider Demographics
NPI:1851345961
Name:ABINGTON MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:ABINGTON MEMORIAL HOSPITAL
Other - Org Name:WARMINSTER FAMILY PRACTICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:KELLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-481-2600
Mailing Address - Street 1:615 SAINT DAVIDS AVE
Mailing Address - Street 2:
Mailing Address - City:WARMINSTER
Mailing Address - State:PA
Mailing Address - Zip Code:18974-2511
Mailing Address - Country:US
Mailing Address - Phone:215-675-2100
Mailing Address - Fax:215-675-7311
Practice Address - Street 1:615 SAINT DAVIDS AVE
Practice Address - Street 2:
Practice Address - City:WARMINSTER
Practice Address - State:PA
Practice Address - Zip Code:18974-2511
Practice Address - Country:US
Practice Address - Phone:215-675-2100
Practice Address - Fax:215-675-7311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-22
Last Update Date:2007-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0000XAllopathic & Osteopathic PhysiciansFamily MedicineAdolescent MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA901243Medicare PIN