Provider Demographics
NPI:1700909595
Name:MERAKEY PHILADELPHIA
Entity Type:Organization
Organization Name:MERAKEY PHILADELPHIA
Other - Org Name:NHS PHILADELPHIA
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CORP SR. DIRECTOR OF BUSINESS OPS
Authorized Official - Prefix:MR
Authorized Official - First Name:NORMAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:TILSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:215-836-3131
Mailing Address - Street 1:620 GERMANTOWN PIKE
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19444-1810
Mailing Address - Country:US
Mailing Address - Phone:215-836-3131
Mailing Address - Fax:215-273-5975
Practice Address - Street 1:27 E MOUNT AIRY AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19119-1713
Practice Address - Country:US
Practice Address - Phone:215-836-3131
Practice Address - Fax:215-273-5975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1000017350083Medicaid
PA1000017350169Medicaid
PA1000017350082Medicaid
PA1000017350151Medicaid
PA1000017350170Medicaid
PA1000017350084Medicaid