Basic Information
Provider Information | |||||||||
NPI: | 1225267024 | ||||||||
EntityType: | 2 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: | GERIATRIC & MEDICAL SERVICES INC | ||||||||
LastName: |   | ||||||||
FirstName: |   | ||||||||
MiddleName: |   | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: |   | ||||||||
OtherOrganizationName: | GENESIS HEALTHCARE AT SPRING MILL | ||||||||
OtherOrganizationType: | 3 | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 101 E STATE ST | ||||||||
Address2: |   | ||||||||
City: | KENNETT SQUARE | ||||||||
State: | PA | ||||||||
PostalCode: | 193483109 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 6109254436 | ||||||||
FaxNumber: | 6103474099 | ||||||||
Practice Location | |||||||||
Address1: | 3000 BALFOUR CIRLE | ||||||||
Address2: |   | ||||||||
City: | PHOENIXVILLE | ||||||||
State: | PA | ||||||||
PostalCode: | 194602140 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 6109254436 | ||||||||
FaxNumber: |   | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 07/14/2009 | ||||||||
LastUpdateDate: | 07/14/2009 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: |   | ||||||||
AuthorizedOfficialLastName: | DROPESKEY | ||||||||
AuthorizedOfficialFirstName: | JANE | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: | CORPORATE MANAGER | ||||||||
AuthorizedOfficialTelephone: | 6109254231 | ||||||||
IsSoleProprietor: |   | ||||||||
IsOrganizationSubpart: | N | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | 0000 | PA | Y |   | Nursing & Custodial Care Facilities | Skilled Nursing Facility |   |
No ID Information.