Provider Demographics
NPI:1649468380
Name:SHOEMAKER CHIROPRACTIC CENTER, LLC
Entity type:Organization
Organization Name:SHOEMAKER CHIROPRACTIC CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:SHOEMAKER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:610-865-6111
Mailing Address - Street 1:3384 EASTON AVE
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18020-3450
Mailing Address - Country:US
Mailing Address - Phone:610-865-6111
Mailing Address - Fax:610-865-6111
Practice Address - Street 1:3384 EASTON AVE
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18020-3450
Practice Address - Country:US
Practice Address - Phone:610-865-6111
Practice Address - Fax:610-865-6111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-09
Last Update Date:2013-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-002077-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA02596300OtherCAPITAL BLUE CROSS
P1017719OtherOXFORD HEALTH, INC
PA143949OtherINDEPENDANCE BLUE CROSS
PAU51529OtherAMERIHEALTH ADMINISTRATOR
PA412038OtherHEALTHASSURANCE PA, INC
PAA43949OtherINTERCOUNTY HEALTH PLAN
AS66379540001OtherCIGNA
PA143949OtherHIGHMARK BLUE SHIELD
PA1030862OtherASHN