Provider Demographics
NPI:1225825342
Name:SHANNONDELL, INC.
Entity type:Organization
Organization Name:SHANNONDELL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:RITTENHOUSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-999-3560
Mailing Address - Street 1:5000 SHANNONDELL DR
Mailing Address - Street 2:
Mailing Address - City:AUDUBON
Mailing Address - State:PA
Mailing Address - Zip Code:19403-5684
Mailing Address - Country:US
Mailing Address - Phone:610-728-5400
Mailing Address - Fax:
Practice Address - Street 1:20000 SHANNONDELL DR
Practice Address - Street 2:
Practice Address - City:AUDUBON
Practice Address - State:PA
Practice Address - Zip Code:19403-5653
Practice Address - Country:US
Practice Address - Phone:610-382-9737
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-22
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care