| Commonwealth Clinical Group | |
|
450 S 5th St Reading PA 19602-2642 | |
| (610) 372-5645 | |
| (610) 898-9229 |
| Full Name | Commonwealth Clinical Group |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 450 S 5th St, Reading, Pennsylvania |
| Authorized Official Name and Position | Stacie Basham (BILLING COORDINATOR) |
| Authorized Official Contact | 7175607917 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Commonwealth Clinical Group 41 E Orange St Lancaster PA 17602-2846 Ph: (717) 393-3900 | Commonwealth Clinical Group 450 S 5th St Reading PA 19602-2642 Ph: (610) 372-5645 |
| NPI Number | 1932484482 |
|---|---|
| Provider Enumeration Date | 10/17/2011 |
| Last Update Date | 09/15/2021 |
| Certification Date | 09/15/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932484482 | NPI | - | NPPES |
| 102233443 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 326900 (Pennsylvania) | Primary |
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