Provider Demographics
NPI:1316422322
Name:DOCTOR OFFICE MANAGEMENT, INC.
Entity type:Organization
Organization Name:DOCTOR OFFICE MANAGEMENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:S
Authorized Official - Last Name:DOMINY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-366-7331
Mailing Address - Street 1:409 SECOND AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:COLLEGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19426-3628
Mailing Address - Country:US
Mailing Address - Phone:877-366-7331
Mailing Address - Fax:
Practice Address - Street 1:409 SECOND AVE STE 201
Practice Address - Street 2:
Practice Address - City:COLLEGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:19426-3628
Practice Address - Country:US
Practice Address - Phone:877-366-7331
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-26
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center