| Phileo District | |
|
6401 Ogontz Ave Philadelphia PA 19126-3406 | |
| (267) 874-6694 | |
| Not Available |
| Full Name | Phileo District |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 6401 Ogontz Ave, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Steven Z Johnson (DEVELOPMENT OFFICER) |
| Authorized Official Contact | 2678647794 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Phileo District 6901 Old York Rd C404 Philadelphia PA 19126-2234 Ph: (267) 864-7794 | Phileo District 6401 Ogontz Ave Philadelphia PA 19126-3406 Ph: (267) 874-6694 |
| NPI Number | 1427589589 |
|---|---|
| Provider Enumeration Date | 03/21/2017 |
| Last Update Date | 03/21/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427589589 | NPI | - | NPPES |
| 1028532600001 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 1208532600001 (Pennsylvania) | Primary |
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