| Prospect Ccmc, Llc | |
|
301 W 15th St Chester PA 19013-5300 | |
| (610) 619-8700 | |
| (610) 619-7331 |
| Full Name | Prospect Ccmc, Llc |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 301 W 15th St, Chester, Pennsylvania |
| Authorized Official Name and Position | Robert Jon Elders (SECRETARY) |
| Authorized Official Contact | 7147881249 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prospect Ccmc, Llc 1 Medical Center Blvd Chester PA 19013-3902 Ph: (610) 447-2000 | Prospect Ccmc, Llc 301 W 15th St Chester PA 19013-5300 Ph: (610) 619-8700 |
| NPI Number | 1255785390 |
|---|---|
| Provider Enumeration Date | 04/14/2016 |
| Last Update Date | 01/15/2021 |
| Certification Date | 01/15/2021 |
| Medicare PECOS PAC ID | 0749571990 |
|---|---|
| Medicare Enrollment ID | O20160621002422 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255785390 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | (* (Not Available)) | Primary |
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