| Brookside Family Practice | |
|
1555 Medical Drive Pottstown PA 19464 | |
| (610) 326-7820 | |
| (610) 326-4068 |
| Full Name | Brookside Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 1555 Medical Drive, Pottstown, Pennsylvania |
| Authorized Official Name and Position | Shana M Enochs (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 6103274200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brookside Family Practice 1555 Medical Drive Pottstown PA 19464 Ph: (610) 326-7820 | Brookside Family Practice 1555 Medical Drive Pottstown PA 19464 Ph: (610) 326-7820 |
| NPI Number | 1033234133 |
|---|---|
| Provider Enumeration Date | 03/20/2007 |
| Last Update Date | 07/14/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033234133 | NPI | - | NPPES |
| 0045725011 | Other | PA | KEYSTONE HMO |
| 26191 | Other | PA | BLUE SHIELD ASSIGN ACCT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MD027759E (Pennsylvania) | Primary |
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