Provider Demographics
NPI:1841351046
Name:SCHUYLKILL CARDIOLOGY CONSULTANTS, P.C.
Entity type:Organization
Organization Name:SCHUYLKILL CARDIOLOGY CONSULTANTS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:BANNING
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:570-668-5650
Mailing Address - Street 1:17 WEST BROAD STREET
Mailing Address - Street 2:
Mailing Address - City:TAMAQUA
Mailing Address - State:PA
Mailing Address - Zip Code:18252
Mailing Address - Country:US
Mailing Address - Phone:570-668-5650
Mailing Address - Fax:570-668-6078
Practice Address - Street 1:17 WEST BROAD STREET
Practice Address - Street 2:
Practice Address - City:TAMAQUA
Practice Address - State:PA
Practice Address - Zip Code:18252
Practice Address - Country:US
Practice Address - Phone:570-668-5650
Practice Address - Fax:570-668-6078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018106310004Medicaid
PA039532Medicare ID - Type UnspecifiedGROUP NUMBER