Provider Demographics
NPI:1891440871
Name:EMPOWER DIABETES EDUCATION LLC
Entity Type:Organization
Organization Name:EMPOWER DIABETES EDUCATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER & CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:
Authorized Official - Last Name:GARRON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-996-9660
Mailing Address - Street 1:249 GREEN TREE DR
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19382-8408
Mailing Address - Country:US
Mailing Address - Phone:610-996-9660
Mailing Address - Fax:
Practice Address - Street 1:249 GREEN TREE DR
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19382-8408
Practice Address - Country:US
Practice Address - Phone:610-996-9660
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-17
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service