| Gpha - Alcorn School Based Health Suite | |
|
3200 Dickinson Street Philadelphia PA 19146-9733 | |
| (215) 220-9002 | |
| (215) 689-1418 |
| Full Name | Gpha - Alcorn School Based Health Suite |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 3200 Dickinson Street, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | D. Tina Smith (PROVIDER ENROLLMENT SPEC.) |
| Authorized Official Contact | 2159252400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gpha - Alcorn School Based Health Suite 1401 S 31st St Fl 2 Philadelphia PA 19146-3506 Ph: (215) 925-2400 | Gpha - Alcorn School Based Health Suite 3200 Dickinson Street Philadelphia PA 19146-9733 Ph: (215) 220-9002 |
| NPI Number | 1235653080 |
|---|---|
| Provider Enumeration Date | 08/02/2017 |
| Last Update Date | 08/02/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235653080 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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