Provider Demographics
NPI:1396743910
Name:MONTGOMERY HOSPITAL
Entity type:Organization
Organization Name:MONTGOMERY HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SENIOR VICE PRESIDENT AND CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:W
Authorized Official - Last Name:LADELY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-270-2067
Mailing Address - Street 1:1301 POWELL ST
Mailing Address - Street 2:P.O. BOX 0992
Mailing Address - City:NORRISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19401-3323
Mailing Address - Country:US
Mailing Address - Phone:610-270-2000
Mailing Address - Fax:
Practice Address - Street 1:1301 POWELL ST
Practice Address - Street 2:
Practice Address - City:NORRISTOWN
Practice Address - State:PA
Practice Address - Zip Code:19401-3323
Practice Address - Country:US
Practice Address - Phone:610-270-2000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-08
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA390801282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA08296OtherHEALTH PARTNERS
PA30619OtherBLACK LUNG
PA390108/P00914OtherPGBA TRICARE
PA0001106000OtherBLUE CROSS PRODUCTS
PAIY0091OtherHEALTH NET
PA504483OtherCIGNA
PA100774444-0002Medicaid
PA390108OtherAMERIHEALTH ADMINISTRATOR
PA00758608-04OtherAMERICHOICE
PA70002OtherKEYSTONE/MERCY
PA0001325OtherAETNA
PA70002OtherAMERIHEALTH MERCY
PA30619OtherBLACK LUNG