PROSPECT CCMC, LLC (NPI# 1750943445) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750943445 |
| Entity Type | Organization |
| Organization Name | PROSPECT CCMC, LLC |
| Practice Address |
800 Macdade Blvd Collingdale PA 19023-3826 |
| Practice Telephone | 3109434500 |
| Enumeration Date | 2019-07-02 |
| Last Update Date | 2019-07-02 |
| Authorized Official Name | LESLIE PRIZANT (ASSOCIATE GENERAL COUNSEL) |
| Authorized Official Telephone | 3109434500 |
| 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 |
|---|---|
| The Delco Academy | Doing Business As Name - Organization |
| 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 |
| 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 |
800 MACDADE BLVD |
| City | COLLINGDALE |
| State | PA |
| Zip Code | 19023-3826 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023177987 | Kimberly Gruden | Social Worker | 800 Macdade Blvd, Collingdale, PA 19023-3826 | 2006-12-07 |
| 1477113249 | Prospect Ccmc, LLC | Clinic/Center | 800 Macdade Blvd, Collingdale, PA 19023-3826 | 2019-06-14 |
| 1043795180 | Jeffane Bernardin | Counselor | 800 Macdade Blvd, Collingdale, PA 19023-3826 | 2018-09-25 |
| 1518356120 | Samantha Tahirak | Counselor | 800 Macdade Blvd, Collingdale, PA 19023-3826 | 2015-01-20 |
| 1770987851 | Spencer Killian | Counselor | 800 Macdade Blvd, Collingdale, PA 19023-3826 | 2014-10-17 |
| 1487054326 | Raven Buchanan | Counselor | 800 Macdade Blvd, Collingdale, PA 19023-3826 | 2014-08-28 |
| 1306246608 | Melissa Mckeown | Social Worker | 800 Macdade Blvd, Collingdale, PA 19023-3826 | 2014-08-25 |
| 1316367030 | Alissa Walsh | Counselor | 800 Macdade Blvd, Collingdale, PA 19023-3826 | 2014-04-21 |
| 1174951735 | Megan Montgomery | Counselor | 800 Macdade Blvd, Collingdale, PA 19023-3826 | 2013-10-17 |
| 1619302015 | Gabrielle Zito | Social Worker | 800 Macdade Blvd, Collingdale, PA 19023-3826 | 2013-09-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972113348 | Ibrahim Abdulkadir Ahmed | Student in an Organized Health Care Education/Training Program | Mercy Catholic Medical Center, 1500 Lansdowne Avenue, Darby, PA 19023 | 2020-07-31 |
| 1437796497 | Elizabeth Megan Heyer | Emergency Medicine | 1500 Lansdowne Aveune, Darby, PA 19023 | 2019-12-09 |
| 1003476813 | Nicole Tomkowich | Student in an Organized Health Care Education/Training Program | 500 Lansdowne Avenue, Darby, PA 19023 | 2019-06-14 |
| 1497220131 | Margaret Kathleen Halloran | Nurse Practitioner | 1501 Lansdowne Ave Mob, 1st Floor, Darby, PA 19023 | 2018-10-09 |
| 1427428705 | Peter Goanue | Counselor | 207 North 2nd Street, Darby, PA 19023 | 2015-09-30 |
| 1518363696 | Trucompanion Transportation Service | Non-emergency Medical Transport (VAN) | 100 N 6th Street Apt 2, Darby, PA 19023 | 2014-11-17 |
| 1366872269 | Chirman Beatty | Licensed Practical Nurse | 400 S. 5th St Apt A9, Darby, PA 19023 | 2013-11-14 |
| 1639514151 | Advanced Nursing Care Inc | Nursing Care | 217 Clifton Avenue, Suite # 8, Collingdale, PA 19023 | 2013-05-10 |
| 1114277191 | Ayesha Farooq | Dentist | 14 Macdave Blvd, Gentle Dental, Collingdale, PA 19023 | 2012-09-17 |
| 1366736787 | Gi Medical Associates | Internal Medicine | 320 Macdade Blvd., Collingdale, PA 19023 | 2011-06-02 |
| Find all providers in zip 19023 | ||||
| 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 |
|---|---|---|---|---|
| 1427600378 | Charles Mitchell Jackson | Clinic/Center | 320 Macdade Blvd Ste 205, Collingdale, PA 19023-1926 | 2019-07-11 |
| 1477113249 | Prospect Ccmc, LLC | Clinic/Center | 800 Macdade Blvd, Collingdale, PA 19023-3826 | 2019-06-14 |
| 1215073507 | Crozer-chester Medical Center | Clinic/Center | 800 Macdade Blvd, Collingdale, PA 19023 | 2007-01-30 |
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|---|---|---|---|---|
| 1144820754 | The Nava Center, Inc. | Clinic/Center | 1334 S 18th St, Philadelphia, PA 19146-4647 | 2020-11-01 |
| 1629680319 | Innovative Pediatric Therapy Services LLC | Clinic/Center | 713 Bridge St Ste 23, Selinsgrove, PA 17870-1250 | 2020-08-24 |
| 1376161828 | Cerner Health Connections, Inc | Clinic/Center | 1234 West Chester Pike, West Chester, PA 19382-5688 | 2020-07-10 |
| 1811514417 | Care Counseling & Children's Services LLC | Clinic/Center | 872 Pennsylvania St, Whitehall, PA 18052-7968 | 2020-06-30 |
| 1629694880 | Lancaster General Medical Group | Clinic/Center | 2112 Harrisburg Pike Ste 323, Lancaster, PA 17601-2644 | 2020-06-23 |
| 1225653496 | Aeo Pitt | Clinic/Center | 77 Hot Metal St, Pittsburgh, PA 15203-2382 | 2020-06-12 |
| 1174147656 | Paul Witt Do Pllc | Clinic/Center | 59 East Carey Street, Plains, PA 18705-1870 | 2020-06-01 |
| 1306469309 | Everest Pace Center Inc | Clinic/Center | 2602 W 9th St Ste 100, Chester, PA 19013-2089 | 2020-05-26 |
| 1225650930 | The Modern Country Doctor, LLC | Clinic/Center | 23 Industrial Blvd Ste D, Paoli, PA 19301-1601 | 2020-05-15 |
| 1013543099 | Rediclinic of Pa, LLC | Clinic/Center | 5707 Easton Rd, Pipersville, PA 18947-1823 | 2020-03-21 |
| Find all providers with the same taxonomy | ||||
| City | COLLINGDALE |
| Zip Code | 19023 |
Please comment or provide details below to improve the information on PROSPECT CCMC, LLC.
| 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.