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500 Adams Avenue Philadelphia PA 19120-2102 | |
| (215) 279-6666 | |
| (215) 279-9674 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 500 Adams Avenue, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Frank Killian (DIRECTOR-OPERATIONS) |
| Authorized Official Contact | 2159852514 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
260 S Broad St Fl 18 Philadelphia PA 19102-5000 Ph: (215) 985-2514 | 500 Adams Avenue Philadelphia PA 19120-2102 Ph: (215) 279-6666 |
| NPI Number | 1750395653 |
|---|---|
| Provider Enumeration Date | 07/28/2006 |
| Last Update Date | 04/11/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750395653 | NPI | - | NPPES |
| G001140710 | Other | PA | AMERICHOICE OF PA |
| 2287757001 | Other | PA | INDEPENDENCE BLUE CROSS |
| 30010912 | Other | PA | KEYSTONE MERCY |
| 33926 | Other | PA | HEALTH PARTNERS OF PA |
| 001599865 | Other | PA | PA HIGHMARK BLUE SHIELD |
| 85942 | Other | PA | AETNA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Pennsylvania) | Primary |
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