| Mercy Sports Medicine | |
|
716 W Germantown Pike East Norriton PA 19403-4255 | |
| (610) 631-2159 | |
| (610) 631-7645 |
| Full Name | Mercy Sports Medicine |
|---|---|
| Speciality | Family Medicine - Sports Medicine |
| Location | 716 W Germantown Pike, East Norriton, Pennsylvania |
| Authorized Official Name and Position | Peter B Kenniff (CFO) |
| Authorized Official Contact | 6106312159 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mercy Sports Medicine 1 W Elm St Suite 100 Conshohocken PA 19428-4108 Ph: (610) 567-6967 | Mercy Sports Medicine 716 W Germantown Pike East Norriton PA 19403-4255 Ph: (610) 631-2159 |
| NPI Number | 1104013085 |
|---|---|
| Provider Enumeration Date | 09/25/2007 |
| Last Update Date | 08/22/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104013085 | NPI | - | NPPES |
| 2097129000 | Other | PA | KHPE |
| 1026335 | Other | PA | KMHP |
| 5178482 | Other | PA | AUSHC PPO |
| 5399 | Other | PA | AUSHC HMO |
| DE1404878 | Other | PA | HIGHMARK BLUE SHIELD |
| 100759466 0038 | Medicaid | PA | |
| 202264000 | Other | PA | OWCP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QS0010X | Family Medicine - Sports Medicine | (* (Not Available)) | Primary |
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