Provider Demographics
NPI:1851607154
Name:GWYNEDD MERCY HEALTH CENTER
Entity Type:Organization
Organization Name:GWYNEDD MERCY HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:A
Authorized Official - Last Name:VANACORE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, CRNP
Authorized Official - Phone:215-855-2289
Mailing Address - Street 1:51 MEDICAL CAMPUS DR
Mailing Address - Street 2:
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-1254
Mailing Address - Country:US
Mailing Address - Phone:215-855-2289
Mailing Address - Fax:267-885-2925
Practice Address - Street 1:51 MEDICAL CAMPUS DR
Practice Address - Street 2:
Practice Address - City:LANSDALE
Practice Address - State:PA
Practice Address - Zip Code:19446-1254
Practice Address - Country:US
Practice Address - Phone:215-855-2289
Practice Address - Fax:267-885-2925
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GWYNEDD MERCY UNIVERSITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-08-24
Last Update Date:2018-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care