| Maria De Los Santos Health Center | |
|
401 55 W Allegheny Ave Philadelphia PA 19133-3644 | |
| (215) 291-2500 | |
| (215) 291-2587 |
| Full Name | Maria De Los Santos Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 401 55 W Allegheny Ave, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Alvan Scott Mcneal (PRESIDENT & CEO) |
| Authorized Official Contact | 2156845344 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Maria De Los Santos Health Center 1412 Fairmount Ave Philadelphia PA 19130-2908 Ph: (215) 599-4851 | Maria De Los Santos Health Center 401 55 W Allegheny Ave Philadelphia PA 19133-3644 Ph: (215) 291-2500 |
| NPI Number | 1114940582 |
|---|---|
| Provider Enumeration Date | 07/25/2006 |
| Last Update Date | 09/08/2021 |
| Medicare PECOS PAC ID | 8426967175 |
|---|---|
| Medicare Enrollment ID | O20030214000039 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114940582 | NPI | - | NPPES |
| 1007729960022 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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