Provider Demographics
NPI:1730356437
Name:PENNSYLVANIA FRANCHISE AUTHORITY
Entity type:Organization
Organization Name:PENNSYLVANIA FRANCHISE AUTHORITY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:REX
Authorized Official - Middle Name:
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:CPED
Authorized Official - Phone:717-731-5600
Mailing Address - Street 1:5080D JONESTOWN RD
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17112-4906
Mailing Address - Country:US
Mailing Address - Phone:717-731-5600
Mailing Address - Fax:
Practice Address - Street 1:3401 HARTZDALE DR
Practice Address - Street 2:SUITE 128
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-7200
Practice Address - Country:US
Practice Address - Phone:717-731-5600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-12
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA6000006672335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier