Provider Demographics
NPI:1891766242
Name:RIDDLE MEMORIAL HOSPITAL - HB / HHA
Entity Type:Organization
Organization Name:RIDDLE MEMORIAL HOSPITAL - HB / HHA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT / CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:W
Authorized Official - Last Name:EYLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-891-3368
Mailing Address - Street 1:1068 W BALTIMORE PIKE
Mailing Address - Street 2:
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-5104
Mailing Address - Country:US
Mailing Address - Phone:610-566-9400
Mailing Address - Fax:610-891-3592
Practice Address - Street 1:1068 W BALTIMORE PIKE
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-5104
Practice Address - Country:US
Practice Address - Phone:610-566-9400
Practice Address - Fax:610-891-3592
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA742505251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA39-7425Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER