PROSPECT CCMC, LLC (NPI# 1578927885) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578927885 |
| Entity Type | Organization |
| Organization Name | PROSPECT CCMC, LLC |
| Other Organization Name | TOBY FARMS OUTPATIENT CLINIC |
| Practice Address |
201 Bridgewater Rd Chester PA 19015-2113 |
| Practice Telephone | 6104977232 |
| Mailing Telephone | 6104977232 |
| Enumeration Date | 2016-04-12 |
| Last Update Date | 2016-04-12 |
| 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 | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| toby farms outpatient clinic | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043674351 | Prospect Ccmc, LLC | Clinic/Center | 100 Crozerville Rd, Aston, PA 19014-1444 | 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 |
| 1184071177 | Prospect Ccmc, LLC | Case Management | 301 W 15th St, Chester, PA 19013-5300 | 2016-05-19 |
| Street Address |
201 BRIDGEWATER RD |
| City | CHESTER |
| State | PA |
| Zip Code | 19015-2113 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487262614 | Hometown Rx Services | Pharmacy | 3406 Edgmont Avenue, Suite B, Brookhaven, PA 19015 | 2020-07-14 |
| 1932650926 | Giant Food Stores LLC | Durable Medical Equipment & Medical Supplies | 4930 Edgemont Ave, Brookhaven, PA 19015 | 2016-10-14 |
| 1982009254 | Communities of Don Guanella and Divine Providence | Intermediate Care Facility, Mentally Retarded | 225 Upland Road, Brookhaven, PA 19015 | 2014-10-29 |
| 1790959633 | Darlene M Longstreth | Massage Therapist | 3766 Susan Lane, Kinderssage, Brookhaven, PA 19015 | 2008-04-22 |
| 1538205463 | Scott Thomas Steltz | Pharmacist | 601 Upland Ave Suite 112, Steltec Pharmacy - Crozier Mills Enterprise Center, Upland, PA 19015 | 2007-01-29 |
| 1083769327 | Parkside Fire Company | Ambulance | 107 West Roland, Parkside, PA 19015 | 2007-01-25 |
| 1295894699 | Elizabeth Katherine Deegan | Counselor | 4928 Shepard St., Brookhaven, PA 19015 | 2006-12-08 |
| 1013093244 | Jeffrey Keith Rosen | Family Medicine | 100 East Brookhaven Rd, Brookhaven, PA 19015 | 2006-10-31 |
| 1013015726 | Pennsylvania Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 3298 Edgemont Ave, Brookhaven, PA 19015 | 2006-09-20 |
| 1285743187 | Micheal A Erbicella | Dentist | 3213 Edgmont Ave, Brookhaven, PA 19015 | 2006-08-30 |
| Find all providers in zip 19015 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306469309 | Everest Pace Center Inc | Clinic/Center | 2602 W 9th St Ste 100, Chester, PA 19013-2089 | 2020-05-26 |
| 1225299837 | Kent Island Chiropractic and Rehabilitation | Clinic/Center | 1812 Main St., Suite C, Chester, MD 21619 | 2008-06-17 |
| 1164568960 | Crozer-chester Medical Center | Clinic/Center | 2600 W 9th Street, Chester, PA 19013-2040 | 2007-01-29 |
| 1477592400 | Aids Care Group | Clinic/Center | 2304 Edgmont Ave, Chester, PA 19013-5038 | 2006-06-05 |
| 1235117417 | Chester Clinic Professional Corp | Clinic/Center | 2319 Old Plank Rd, Chester, IL 62233 | 2006-01-06 |
| 1881170579 | Fit and Centered LLC | Clinic/Center | 76 Main St, Chester, NJ 07930-2551 | 2018-07-16 |
| 1619463791 | We Care Clinic | Clinic/Center | 9 Chester Plz, Chester, MD 21619-2418 | 2018-07-02 |
| 1427595982 | Prospect Ccmc, LLC | Clinic/Center | 1 Medical Center Blvd, Chester, PA 19013-3902 | 2017-01-23 |
| 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 |
| Find all providers in CHESTER | ||||
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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.