Provider Demographics
NPI:1235208760
Name:DOYLESTOWN MEDICAL CENTER INC.
Entity type:Organization
Organization Name:DOYLESTOWN MEDICAL CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:OLIVERIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-658-2081
Mailing Address - Street 1:5225 WOOSTER RD W
Mailing Address - Street 2:
Mailing Address - City:NORTON
Mailing Address - State:OH
Mailing Address - Zip Code:44203-6262
Mailing Address - Country:US
Mailing Address - Phone:330-658-2081
Mailing Address - Fax:
Practice Address - Street 1:5225 WOOSTER RD W
Practice Address - Street 2:
Practice Address - City:NORTON
Practice Address - State:OH
Practice Address - Zip Code:44203-6262
Practice Address - Country:US
Practice Address - Phone:330-658-2081
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2016-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34003750207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2179360Medicaid
OHCH5515OtherRAILROAD MEDICARE
OH2179360Medicaid
OH9305461Medicare UPIN