| Organization Name: | ST. MARY CHILDREN'S HEALTH CENTER |
| NPI Number: | 1083622286 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JILL SIMON (PEDIATRIC NURSE PRACTITIONER/MANAGE) |
| Mailing Address: | 2546 Knights Rd Bensalem |
| State: | PA US |
| Postal Code: | 190203400 |
| Phone Number: | 2152458873 |
| Fax Number: | 2152458895 |
| NPI Enumeration Date: | 08/03/2006 |
| NPI Last Update Date: | 03/28/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QH0100X |
| License Number: | 1007731420020 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Health Service |
| Taxonomy Definition: | |