| Devereux Whitlock Center | |
|
139 Leopard Rd Berwyn PA 19312-1809 | |
| (610) 296-6800 | |
| (610) 251-2013 |
| Full Name | Devereux Whitlock Center |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 139 Leopard Rd, Berwyn, Pennsylvania |
| Authorized Official Name and Position | Fran Wagner (NATIONAL ACCTS RECEIVABLE DIRECTOR) |
| Authorized Official Contact | 6105423084 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Devereux Whitlock Center 139 Leopard Rd Berwyn PA 19312-1809 Ph: (610) 296-6800 | Devereux Whitlock Center 139 Leopard Rd Berwyn PA 19312-1809 Ph: (610) 296-6800 |
| NPI Number | 1174664742 |
|---|---|
| Provider Enumeration Date | 02/08/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174664742 | NPI | - | NPPES |
| 1000019130415 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 102780 (Pennsylvania) | Primary |
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