Provider Demographics
NPI:1992923262
Name:DOCTORS EXPRESS CARE LLC
Entity type:Organization
Organization Name:DOCTORS EXPRESS CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BROLLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-853-9900
Mailing Address - Street 1:737 W CHESTER PIKE
Mailing Address - Street 2:
Mailing Address - City:HAVERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19083-4441
Mailing Address - Country:US
Mailing Address - Phone:610-853-9900
Mailing Address - Fax:610-853-0169
Practice Address - Street 1:737 W CHESTER PIKE
Practice Address - Street 2:
Practice Address - City:HAVERTOWN
Practice Address - State:PA
Practice Address - Zip Code:19083-4441
Practice Address - Country:US
Practice Address - Phone:610-853-9900
Practice Address - Fax:610-853-0169
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA93168962207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA092539Medicare ID - Type Unspecified
PAC32929Medicare UPIN