| |
420 N 20th St, Philadelphia, PA 19130-3828 | |
(215) 496-2662 | |
(215) 496-1349 |
Full Name | |
---|---|
Type | Facility |
Speciality | Home Delivered Meals |
Location | 420 N 20th St, Philadelphia, Pennsylvania |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1730399064 | NPI | - | NPPES |
001542272-0003 | Medicaid | PA | |
001542272-0002 | Medicaid | PA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
133V00000X | Dietitian, Registered | (Pennsylvania) | Secondary |
332U00000X | Home Delivered Meals | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
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420 N 20th St, Philadelphia, PA 19130-3828 Ph: (215) 496-2662 | 420 N 20th St, Philadelphia, PA 19130-3828 Ph: (215) 496-2662 |