Provider Demographics
NPI:1538573563
Name:ARK PAIN MANAGEMENT, LLC
Entity type:Organization
Organization Name:ARK PAIN MANAGEMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JHA
Authorized Official - Middle Name:
Authorized Official - Last Name:BHAWNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-797-2879
Mailing Address - Street 1:400 OLD FORGE LN
Mailing Address - Street 2:SUITE 407
Mailing Address - City:KENNETT SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19348-1914
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:400 OLD FORGE LN
Practice Address - Street 2:SUITE 407
Practice Address - City:KENNETT SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19348-1914
Practice Address - Country:US
Practice Address - Phone:856-797-2879
Practice Address - Fax:856-797-1288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-18
Last Update Date:2014-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty