Provider Demographics
NPI:1851456123
Name:AQUABILITIES, INC.
Entity Type:Organization
Organization Name:AQUABILITIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KRIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:KENNEDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-582-2348
Mailing Address - Street 1:320 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BIRDSBORO
Mailing Address - State:PA
Mailing Address - Zip Code:19508-1900
Mailing Address - Country:US
Mailing Address - Phone:610-582-2348
Mailing Address - Fax:610-528-3938
Practice Address - Street 1:320 W MAIN ST
Practice Address - Street 2:
Practice Address - City:BIRDSBORO
Practice Address - State:PA
Practice Address - Zip Code:19508-1900
Practice Address - Country:US
Practice Address - Phone:610-582-2348
Practice Address - Fax:610-528-3938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0368299000OtherKEYSTONE HEALTH PLAN EAST
PA02752300OtherCAPITAL BLUE CROSS
PA952915OtherBLUE SHIELD
PA02752300OtherCAPITAL BLUE CROSS