Provider Demographics
NPI:1962452805
Name:PHOENIXVILLE HOSPITAL COMPANY, LLC
Entity Type:Organization
Organization Name:PHOENIXVILLE HOSPITAL COMPANY, LLC
Other - Org Name:CARDIOTHORACIC SURGICAL SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR VP
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:NEWSOME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-983-1561
Mailing Address - Street 1:824 MAIN ST
Mailing Address - Street 2:SUITE 302
Mailing Address - City:PHOENIXVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19460-4478
Mailing Address - Country:US
Mailing Address - Phone:610-983-1561
Mailing Address - Fax:610-983-1569
Practice Address - Street 1:824 MAIN ST
Practice Address - Street 2:SUITE 302
Practice Address - City:PHOENIXVILLE
Practice Address - State:PA
Practice Address - Zip Code:19460-4478
Practice Address - Country:US
Practice Address - Phone:610-983-1561
Practice Address - Fax:610-983-1569
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical OncologyGroup - Multi-Specialty