Bustleton Healthcare
LBN: Bustleton Healthcare
Bustleton Healthcare is an health care organization with primary practice located at 9867 Bustleton Ave Suite B, Philadelphia PA 19115-2611. The organization recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Medical Specialty, Ambulatory Health Care Facilities / Primary Care. Ambulatory Health Care Facilities / Primary Care is the primary health care specialty.
Bustleton Healthcare can be contacted via phone (215) 698-9295, or through Joukova, Irina via phone (267) 307-9236.
Contact Information
Primary practice address
9867 Bustleton Ave Suite B
Philadelphia PA 19115-2611
Phone: (215) 698-9295
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Medical Specialty | 261QM2500X | MD 435017 | Pennsylvania |
| Ambulatory Health Care Facilities / Primary Care | 261QP2300X | MD 435017 | Pennsylvania |
Profile Details
| NPI number | 1588107668 |
|---|---|
| LBN Legal business name | Bustleton Healthcare |
| DBA Doing business as | |
| Authorized official | Joukova, Irina |
| Entity | Organization |
| Organization subpart 1 | Yes |
| Enumeration date | Nov 22nd, 2016 |
| Last updated | Nov 22nd, 2016 - about 8 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1588107668 | NPPES |
| Pennsylvania | MEDICAID | 102790572 0001 |
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