Provider Demographics
NPI:1700806189
Name:ARIA HEALTH PROVIDER SERVICES
Entity Type:Organization
Organization Name:ARIA HEALTH PROVIDER SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT AHFS
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:KUMOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-837-2023
Mailing Address - Street 1:PO BOX 8500-6335
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-0001
Mailing Address - Country:US
Mailing Address - Phone:215-807-8000
Mailing Address - Fax:215-807-8345
Practice Address - Street 1:3998 RED LION RD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19114-1436
Practice Address - Country:US
Practice Address - Phone:215-612-4000
Practice Address - Fax:215-807-8235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2015-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207Q00000X, 207R00000X
PA207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA3693550001OtherKEYSTONE IBC
PA379767OtherBS ZEMBLE DONER SAKNOFSKY
PA381501OtherBS JUNIATA
PA386631OtherBS OXVALINTMED
PA1007526250041Medicaid
PA1007526250039Medicaid
PA1967565OtherBS - COMMODARO
PA386626OtherBS FCIM
PA1007526250051Medicaid
PA379777OtherBS FHCS PALAT
PA379886OtherBS NEIM
PA1742145OtherBS FHCS R R
PA2088350OtherHIGHMARK BLUE SHIELD
PA379781OtherBS LAMBERT
PA3693550001OtherKEYSTONE IBC