Provider Demographics
NPI:1669130209
Name:BERKS COMMUNITY HEALTH CENTER
Entity type:Organization
Organization Name:BERKS COMMUNITY HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:HELEN
Authorized Official - Last Name:KARGBO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-772-4091
Mailing Address - Street 1:645 PENN ST STE 301
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19601-3527
Mailing Address - Country:US
Mailing Address - Phone:484-772-4091
Mailing Address - Fax:610-374-1629
Practice Address - Street 1:1110 ROCKLAND ST
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19604-1501
Practice Address - Country:US
Practice Address - Phone:610-988-3848
Practice Address - Fax:484-772-1112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-01
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes333600000XSuppliersPharmacyGroup - Single Specialty
No1835P2201XPharmacy Service ProvidersPharmacistAmbulatory CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAAA0003086596Medicaid