Provider Demographics
NPI:1245531714
Name:VILLAGE MEDICAL CENTER ASSOCIATES
Entity type:Organization
Organization Name:VILLAGE MEDICAL CENTER ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:MITMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-903-0643
Mailing Address - Street 1:625 N POTTSTOWN PIKE
Mailing Address - Street 2:
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-1628
Mailing Address - Country:US
Mailing Address - Phone:610-903-0640
Mailing Address - Fax:610-903-0637
Practice Address - Street 1:625 N POTTSTOWN PIKE
Practice Address - Street 2:
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-1628
Practice Address - Country:US
Practice Address - Phone:610-903-0640
Practice Address - Fax:610-903-0637
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-15
Last Update Date:2010-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS011174L261QX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine