Eastern Pennsylvania Physician Alliance Llc

LBN: Eastern Pennsylvania Physician Alliance Llc
Eastern Pennsylvania Physician Alliance Llc is an health care organization with primary practice located at 4641 E Roosevelt Blvd , Philadelphia PA 19124-2343. The organization recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neurology, Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Allopathic & Osteopathic Physicians / Neurology is the primary health care specialty. Eastern Pennsylvania Physician Alliance Llc can be contacted via phone (610) 382-4943, or through Evans, Todd via phone (610) 382-4943.

Contact Information

Primary practice address
4641 E Roosevelt Blvd Philadelphia PA 19124-2343
Phone: (610) 382-4943
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Evans, Todd
Phone: (610) 382-4943

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology 2084N0400X
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X

Profile Details

NPI number 1902440621
LBN Legal business name Eastern Pennsylvania Physician Alliance Llc
DBA Doing business as
Authorized official Evans, Todd
Entity Organization
Organization subpart 1 No
Enumeration date Nov 6th, 2019
Last updated Nov 6th, 2019 - about 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902440621 NPPES
Pennsylvania MEDICAID PENDING

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