Provider Demographics
NPI:1831602747
Name:BERKSHIRE ORTHOPEDICS LLC
Entity type:Organization
Organization Name:BERKSHIRE ORTHOPEDICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-375-4949
Mailing Address - Street 1:2201 RIDGEWOOD RD STE 250
Mailing Address - Street 2:
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-1191
Mailing Address - Country:US
Mailing Address - Phone:610-375-4949
Mailing Address - Fax:610-375-6233
Practice Address - Street 1:1270 BROADCASTING RD
Practice Address - Street 2:
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-3203
Practice Address - Country:US
Practice Address - Phone:610-372-1140
Practice Address - Fax:610-372-7684
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-14
Last Update Date:2017-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103321068Medicaid