Provider Demographics
NPI:1366560583
Name:PER DIEM WITH QUALITY, INC.
Entity type:Organization
Organization Name:PER DIEM WITH QUALITY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GORDON
Authorized Official - Middle Name:S
Authorized Official - Last Name:CLEMENT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-327-2035
Mailing Address - Street 1:PO BOX 1415
Mailing Address - Street 2:
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19464-0893
Mailing Address - Country:US
Mailing Address - Phone:610-327-2035
Mailing Address - Fax:610-327-2035
Practice Address - Street 1:113 EVERGREEN CT
Practice Address - Street 2:
Practice Address - City:BLUE BELL
Practice Address - State:PA
Practice Address - Zip Code:19422-2817
Practice Address - Country:US
Practice Address - Phone:215-654-8186
Practice Address - Fax:215-654-8187
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD009204E208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA018563Medicare PIN