| Health Care Center 4 | |
|
4400 Haverford Ave Philadelphia PA 19104-1361 | |
| (215) 685-7628 | |
| (215) 685-6848 |
| Full Name | Health Care Center 4 |
|---|---|
| Speciality | Clinic/Center |
| Location | 4400 Haverford Ave, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Christine Gaddy (BILLING MANAGER) |
| Authorized Official Contact | 2156856843 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Health Care Center 4 1101 Market St Fl 10 Revenue Management Philadelphia PA 19107-2911 Ph: (215) 685-5306 | Health Care Center 4 4400 Haverford Ave Philadelphia PA 19104-1361 Ph: (215) 685-7628 |
| NPI Number | 1144337189 |
|---|---|
| Provider Enumeration Date | 08/24/2006 |
| Last Update Date | 11/25/2019 |
| Medicare PECOS PAC ID | 6305758723 |
|---|---|
| Medicare Enrollment ID | O20110118000935 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144337189 | NPI | - | NPPES |
| 1000076950010 | Medicaid | PA | |
| G0004755 | Medicaid | PA | |
| 100084 | Medicaid | PA | |
| 33104 | Medicaid | PA | |
| 66692 | Other | PA | HIGHMARK BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Pennsylvania) | Primary |
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