Organization Name: | KEYSTONE MOBILE PARTNERS, LP |
NPI Number: | 1083898787 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MICHAEL A DERNOGA (EXEC. DIRECTOR) |
Mailing Address: | 2701 Blair Mill Rd Ste. 30 Willow Grove |
State: | PA US |
Postal Code: | 190901041 |
Phone Number: | 2156759900 |
Fax Number: | 2156754096 |
NPI Enumeration Date: | 12/18/2007 |
NPI Last Update Date: | 12/18/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QA1903X |
License Number: | 15331501 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Ambulatory Surgical |
Taxonomy Definition: |