| Esperanza Health Center Inc | |
|
4417 N. 6th St. Philadelphia PA 19140-2319 | |
| (215) 302-3600 | |
| (215) 329-2369 |
| Full Name | Esperanza Health Center Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4417 N. 6th St., Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Glenna J Deem (CREDENTIALING MANAGER) |
| Authorized Official Contact | 2153023600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Esperanza Health Center Inc 4417 N. 6th St. Philadelphia PA 19140-2319 Ph: (215) 302-3600 | Esperanza Health Center Inc 4417 N. 6th St. Philadelphia PA 19140-2319 Ph: (215) 302-3600 |
| NPI Number | 1386922714 |
|---|---|
| Provider Enumeration Date | 08/03/2011 |
| Last Update Date | 03/29/2016 |
| Medicare PECOS PAC ID | 6103815071 |
|---|---|
| Medicare Enrollment ID | O20111214000203 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386922714 | NPI | - | NPPES |
| 1007734560009 | Medicaid | PA | |
| 153891 | Other | MEDICARE PART B PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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