Basic Information
Provider Information
NPI: 1578780920
EntityType: 2
ReplacementNPI:  
OrganizationName: GENERAL HEALTHCARE RESOURCES, INC.
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 481 S 550 E
Address2:  
City: MONTGOMERY
State: IN
PostalCode: 47558
CountryCode: US
TelephoneNumber: 8124862785
FaxNumber:  
Practice Location
Address1: 2250 HICKORY RD STE 240
Address2:  
City: PLYMOUTH MEETING
State: PA
PostalCode: 194622225
CountryCode: US
TelephoneNumber: 8008794471
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/19/2007
LastUpdateDate: 08/30/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: ROMANO
AuthorizedOfficialFirstName: BETH
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: CREDENTIALING SUPERVISOR
AuthorizedOfficialTelephone: 8008794471
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
314000000X06002489AINY Nursing & Custodial Care FacilitiesSkilled Nursing Facility 

No ID Information.


Home