Provider Demographics
NPI:1104155696
Name:RISING SUN MEDICAL CENTER
Entity type:Organization
Organization Name:RISING SUN MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF MARKETING AND OPERATIONS
Authorized Official - Prefix:MS
Authorized Official - First Name:DINAH
Authorized Official - Middle Name:L
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-613-7145
Mailing Address - Street 1:5900 RISING SUN AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19120-1117
Mailing Address - Country:US
Mailing Address - Phone:215-613-7145
Mailing Address - Fax:
Practice Address - Street 1:5900 RISING SUN AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19120-1117
Practice Address - Country:US
Practice Address - Phone:215-613-7145
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-14
Last Update Date:2009-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service