Provider Demographics
NPI:1932465168
Name:SILVER CONTINENCE CARE PA, LLC
Entity Type:Organization
Organization Name:SILVER CONTINENCE CARE PA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FRAZER
Authorized Official - Middle Name:
Authorized Official - Last Name:BUNTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-848-7437
Mailing Address - Street 1:1001 HAWKINS ST
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-4758
Mailing Address - Country:US
Mailing Address - Phone:888-848-7437
Mailing Address - Fax:888-215-7042
Practice Address - Street 1:1060 FIRST AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-1336
Practice Address - Country:US
Practice Address - Phone:888-848-7437
Practice Address - Fax:888-215-7042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-02
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA228534Medicare PIN