Provider Demographics
NPI:1770562688
Name:ASHTON HALL INC
Entity type:Organization
Organization Name:ASHTON HALL INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:J
Authorized Official - Last Name:SEGAL
Authorized Official - Suffix:
Authorized Official - Credentials:MHA
Authorized Official - Phone:215-355-6288
Mailing Address - Street 1:106 LAKESIDE DRIVE
Mailing Address - Street 2:
Mailing Address - City:SOUTHAMPTON
Mailing Address - State:PA
Mailing Address - Zip Code:18966
Mailing Address - Country:US
Mailing Address - Phone:215-355-6288
Mailing Address - Fax:215-355-8127
Practice Address - Street 1:2109 RED LION RD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19115-1711
Practice Address - Country:US
Practice Address - Phone:215-673-7000
Practice Address - Fax:215-698-4997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA145350310400000X
PA0114 02314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Not Answered314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0101946401OtherAMERICHOICE
PA0006002 000OtherBLUE CROSS KEYSTONE
PA116981 0001OtherDMERC A MEDICARE
PA000756210 0001Medicaid
PA1052293OtherKEYSTONE MERCY
PA13112OtherAETNA US HEALTHCARE
PA20134OtherHEALTH PARTNERS SENIOR PA
PA395110Medicare ID - Type Unspecified