Provider Demographics
NPI:1912203340
Name:DEVON HEALTH CARE GROUP LLC
Entity Type:Organization
Organization Name:DEVON HEALTH CARE GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:MICHENER
Authorized Official - Suffix:
Authorized Official - Credentials:MSN RN
Authorized Official - Phone:866-830-7272
Mailing Address - Street 1:2103 DARBY RD
Mailing Address - Street 2:
Mailing Address - City:HAVERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19083-2443
Mailing Address - Country:US
Mailing Address - Phone:866-830-7272
Mailing Address - Fax:610-465-9400
Practice Address - Street 1:2103 DARBY RD
Practice Address - Street 2:
Practice Address - City:HAVERTOWN
Practice Address - State:PA
Practice Address - Zip Code:19083-2443
Practice Address - Country:US
Practice Address - Phone:866-830-7272
Practice Address - Fax:610-465-9400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-02
Last Update Date:2011-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty