Provider Demographics
NPI:1700315041
Name:BRANDYWINE FAMILY FOOT CARE, PC
Entity Type:Organization
Organization Name:BRANDYWINE FAMILY FOOT CARE, PC
Other - Org Name:BRANDYWINE FOOT AND ANKLE ASSOCIATES
Other - Org Type:Other Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LORRAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MURRAY
Authorized Official - Suffix:
Authorized Official - Credentials:PMAC
Authorized Official - Phone:610-383-5220
Mailing Address - Street 1:410 W LINFIELD TRAPPE RD STE 120
Mailing Address - Street 2:
Mailing Address - City:LIMERICK
Mailing Address - State:PA
Mailing Address - Zip Code:19468-4200
Mailing Address - Country:US
Mailing Address - Phone:610-495-2040
Mailing Address - Fax:
Practice Address - Street 1:410 W LINFIELD TRAPPE RD STE 120
Practice Address - Street 2:
Practice Address - City:LIMERICK
Practice Address - State:PA
Practice Address - Zip Code:19468-4200
Practice Address - Country:US
Practice Address - Phone:610-495-2040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BRANDYWINE FAMILY FOOT CARE, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-06-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site