Provider Demographics
NPI:1548332836
Name:READING CONVENIENT CARE INC
Entity type:Organization
Organization Name:READING CONVENIENT CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GIRI
Authorized Official - Middle Name:BABU
Authorized Official - Last Name:MANNEPULI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-939-1532
Mailing Address - Street 1:3535 N 5TH STREET HWY
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19605
Mailing Address - Country:US
Mailing Address - Phone:610-939-1532
Mailing Address - Fax:610-939-1535
Practice Address - Street 1:3535 N 5TH STREET HWY
Practice Address - Street 2:READING CONVENIENT CARE
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19605
Practice Address - Country:US
Practice Address - Phone:610-939-1532
Practice Address - Fax:610-939-1535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD062948L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA061722Medicare PIN
H06822Medicare UPIN