Provider Demographics
NPI:1093527533
Name:METHODIST ASSOCIATES HEALTHCARE, INC.
Entity type:Organization
Organization Name:METHODIST ASSOCIATES HEALTHCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIAL SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:VESTA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-955-1175
Mailing Address - Street 1:1101 MARKET ST FL 19
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-2926
Mailing Address - Country:US
Mailing Address - Phone:215-955-6161
Mailing Address - Fax:
Practice Address - Street 1:500 OLD YORK ROAD
Practice Address - Street 2:SUITE 203
Practice Address - City:JENKINTOWN
Practice Address - State:PA
Practice Address - Zip Code:19046-2872
Practice Address - Country:US
Practice Address - Phone:215-886-0174
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-22
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes333600000XSuppliersPharmacy
No183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty