Provider Demographics
NPI:1053773853
Name:21ST CENTURY MEDICAL BILLING
Entity type:Organization
Organization Name:21ST CENTURY MEDICAL BILLING
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:DOLITSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-250-0793
Mailing Address - Street 1:73 BUCK RD STE E
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-1561
Mailing Address - Country:US
Mailing Address - Phone:267-250-0793
Mailing Address - Fax:844-757-3718
Practice Address - Street 1:73 BUCK RD STE E
Practice Address - Street 2:
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006-1561
Practice Address - Country:US
Practice Address - Phone:267-250-0793
Practice Address - Fax:844-757-3718
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-22
Last Update Date:2019-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1032139190001Medicaid