| Philadelphia Dept. Of Public Health | |
|
1101 Market St Fl 12 Philadelphia PA 19107 | |
| (215) 685-6843 | |
| Not Available |
| Full Name | Philadelphia Dept. Of Public Health |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 1101 Market St Fl 12, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Christine Gaddy (BILLING MANAGER) |
| Authorized Official Contact | 2156856843 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Philadelphia Dept. Of Public Health 1101 Market St Fl 12 Philadelphia PA 19107-2934 Ph: (215) 685-6843 | Philadelphia Dept. Of Public Health 1101 Market St Fl 12 Philadelphia PA 19107 Ph: (215) 685-6843 |
| NPI Number | 1821172107 |
|---|---|
| Provider Enumeration Date | 10/24/2006 |
| Last Update Date | 06/11/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821172107 | NPI | - | NPPES |
| 1000076950008 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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