Provider Demographics
NPI:1770719080
Name:BUCKS COUNTY ACCESS CENTER, LLC
Entity type:Organization
Organization Name:BUCKS COUNTY ACCESS CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHITTUR
Authorized Official - Middle Name:R
Authorized Official - Last Name:MOHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-302-7188
Mailing Address - Street 1:444 OXFORD VALLEY RD
Mailing Address - Street 2:STE 100
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-8300
Mailing Address - Country:US
Mailing Address - Phone:215-302-7188
Mailing Address - Fax:215-302-7188
Practice Address - Street 1:444 OXFORD VALLEY RD
Practice Address - Street 2:STE 100
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-8300
Practice Address - Country:US
Practice Address - Phone:215-302-7188
Practice Address - Fax:215-302-7188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-02
Last Update Date:2014-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1023925010001Medicaid
PA161061Medicare PIN