PROSPECT CCMC, LLC (NPI# 1235583386) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235583386 |
| Entity Type | Organization |
| Organization Name | PROSPECT CCMC, LLC |
| Practice Address |
1 Medical Center Blvd Chester PA 19013-3902 |
| Practice Telephone | 6104472000 |
| Practice Fax Number | 6104976620 |
| Mailing Telephone | 6104472000 |
| Mailing Fax Number | 6104976620 |
| Enumeration Date | 2016-04-14 |
| Last Update Date | 2016-04-14 |
| Authorized Official Name | ELLEN SHIN (SECRETARY) |
| Authorized Official Telephone | 3109434520 |
| Authorized Official Credential | JD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 341600000X | Ambulance | Transportation Services |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043674351 | Prospect Ccmc, LLC | Clinic/Center | 100 Crozerville Rd, Aston, PA 19014-1444 | 2016-04-12 |
| 1578927885 | Prospect Ccmc, LLC | Clinic/Center | 201 Bridgewater Rd, Chester, PA 19015-2113 | 2016-04-12 |
| 1740644053 | Prospect Ccmc, LLC | Clinic/Center | 710 S Middletown Rd, Media, PA 19063-5024 | 2016-04-12 |
| 1669084364 | Prospect Ccmc, LLC | Case Management | 301 W 15th St, Chester, PA 19013-5300 | 2020-08-24 |
| 1750943445 | Prospect Ccmc, LLC | Clinic/Center | 800 Macdade Blvd, Collingdale, PA 19023-3826 | 2019-07-02 |
| 1477113249 | Prospect Ccmc, LLC | Clinic/Center | 800 Macdade Blvd, Collingdale, PA 19023-3826 | 2019-06-14 |
| 1427595982 | Prospect Ccmc, LLC | Clinic/Center | 1 Medical Center Blvd, Chester, PA 19013-3902 | 2017-01-23 |
| 1942745211 | Prospect Ccmc, LLC | Clinic/Center | 1 Medical Center Blvd, Chester, PA 19013-3902 | 2016-12-22 |
| 1659728640 | Prospect Ccmc, LLC | Clinic/Center | 1 Medical Center Blvd, Chester, PA 19013-3902 | 2016-05-19 |
| 1376990366 | Prospect Ccmc, LLC | Clinic/Center | 301 W 15th St, Chester, PA 19013 | 2016-05-19 |
| Street Address |
1 MEDICAL CENTER BLVD |
| City | CHESTER |
| State | PA |
| Zip Code | 19013-3902 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124626064 | Rachelle Lynn Dambman | Nurse Practitioner | 1 Medical Center Blvd, Chester, PA 19013-3902 | 2020-10-13 |
| 1588274930 | Hui Chong Lau | Student in an Organized Health Care Education/Training Program | 1 Medical Center Blvd, Chester, PA 19013-3902 | 2020-07-31 |
| 1679194856 | Pooja Manjunatha | Podiatrist | 1 Medical Center Blvd, Chester, PA 19013-3902 | 2020-04-29 |
| 1609497981 | Jessica Hyman | Physician Assistant | 1 Medical Center Blvd, Chester, PA 19013-3995 | 2020-04-28 |
| 1740800242 | Jared Blum | Podiatrist | 1 Medical Center Blvd, Chester, PA 19013-3902 | 2020-04-24 |
| 1487274312 | Patrick Sean Sullivan | Student in an Organized Health Care Education/Training Program | 1 Medical Center Blvd, Chester, PA 19013-3995 | 2020-04-21 |
| 1629698550 | Brett Houston Palmer | Student in an Organized Health Care Education/Training Program | 1 Medical Center Blvd, Chester, PA 19013-3995 | 2020-04-21 |
| 1922627231 | Oluwadara Nnoli | Student in an Organized Health Care Education/Training Program | 1 Medical Center Blvd, Chester, PA 19013-3902 | 2020-04-16 |
| 1730708181 | Sachi Singhal | Student in an Organized Health Care Education/Training Program | 1 Medical Center Blvd, Chester, PA 19013-3995 | 2020-04-15 |
| 1770102014 | Mary Howland Williamson | Student in an Organized Health Care Education/Training Program | 1 Medical Center Blvd, Chester, PA 19013-3902 | 2020-04-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790305043 | Erika Pack | Student in an Organized Health Care Education/Training Program | Crozer-chester Medical Center, 1 Medical Center Blvd., Upland, PA 19013 | 2020-04-16 |
| 1477195287 | Andrew Matthews | Counselor | 301 West 15 Street, Chester, PA 19013 | 2019-10-14 |
| 1780241133 | Raashidah Elizabeth Bowman | Contractor | 1208 Remington Street, Chester, PA 19013 | 2019-05-21 |
| 1134609464 | Shamira Clintonia Johnson | Nurse's Aide | 217 W 5th St, Chester, PA 19013 | 2018-08-16 |
| 1871081299 | Michael Briskey | Student in an Organized Health Care Education/Training Program | 1 Medical Center Blv.d, Chester, PA 19013 | 2018-05-01 |
| 1356845499 | Sonia Gaur | Internal Medicine | 1 Medical Center Blvd Fl 3, Chester, PA 19013 | 2018-03-22 |
| 1548619232 | Beth Barol | Social Worker | 1602 Walnut St, Center for Social Work Education, Chester, PA 19013 | 2016-06-03 |
| 1235594888 | Eryka Jackson | Counselor | 516 West 5th Street, Chester, PA 19013 | 2015-12-28 |
| 1437553146 | Erin Hipple | Counselor | 200 West 9th St, Chester, PA 19013 | 2014-10-09 |
| 1588079867 | Crozer Chester Medical Center | Clinic/Center | 201 Bridgewater Road, Chester Township, PA 19013 | 2014-06-25 |
| Find all providers in zip 19013 | ||||
| Taxonomy Code | 341600000X |
| Grouping | Transportation Services |
| Classification | Ambulance |
| An emergency vehicle used for transporting patients to a health care facility after injury or illness. Types of ambulances used in the United States include ground (surface) ambulance, rotor-wing (helicopter), and fixed-wing aircraft (airplane). |
| Notes: Source: Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 37. |
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|---|---|---|---|---|
| 1497071294 | Town of Chester | Ambulance | 27 Murphy Dr, Chester, NH 03036-8108 | 2010-04-19 |
| 1487642849 | Chester Hose Company Incorporated | Ambulance | 6 High St, Chester, CT 06412-1117 | 2005-10-11 |
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| 1881048155 | P Nicholas Enterprises LLC | Ambulance | 285 Linfield Rd, Parkerford, PA 19457 | 2016-04-22 |
| 1033577259 | Braddock Emergency Medical Services | Ambulance | 1100 Braddock Ave, Braddock, PA 15104-1721 | 2016-02-02 |
| 1851756365 | Express Medical Transport, LLC | Ambulance | 2183 E Village Rd, Holland, PA 18966-2932 | 2015-12-28 |
| 1881066397 | Life Alert Ambulance Inc | Ambulance | 380 Red Lion Rd Ste 216, Huntingdon Valley, PA 19006-6451 | 2015-10-23 |
| 1508260126 | Glenville Ambulance, LLC | Ambulance | 5871 Blooming Grove Rd, Glenville, PA 17329-9413 | 2014-10-09 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.