Provider Demographics
NPI:1992055305
Name:PRIME HEALTHCARE SERVICES LOWER BUCKS LLC
Entity type:Organization
Organization Name:PRIME HEALTHCARE SERVICES LOWER BUCKS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DEPUTY GENERAL COUNSEL
Authorized Official - Prefix:
Authorized Official - First Name:RADHA
Authorized Official - Middle Name:
Authorized Official - Last Name:SAVITALA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-235-4400
Mailing Address - Street 1:3300 E GUASTI RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91761-8655
Mailing Address - Country:US
Mailing Address - Phone:909-235-4400
Mailing Address - Fax:909-235-4419
Practice Address - Street 1:501 BATH RD
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:PA
Practice Address - Zip Code:19007-3101
Practice Address - Country:US
Practice Address - Phone:215-785-9200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-12
Last Update Date:2015-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA39S070Medicare Oscar/Certification