| Spectrum Health Services Inc | |
|
1415 North Broad Street Broad Street Health Center Philadelphia PA 19122 | |
| (215) 235-7944 | |
| (215) 235-0813 |
| Full Name | Spectrum Health Services Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1415 North Broad Street, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Phyllis B Cater (PRESIDENT & CEO) |
| Authorized Official Contact | 2154712761 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Spectrum Health Services Inc 5201 Haverford Ave Spectrum Health Services, Inc Philadelphia PA 19139-1401 Ph: (215) 471-2761 | Spectrum Health Services Inc 1415 North Broad Street Broad Street Health Center Philadelphia PA 19122 Ph: (215) 235-7944 |
| NPI Number | 1881629012 |
|---|---|
| Provider Enumeration Date | 07/12/2006 |
| Last Update Date | 08/18/2015 |
| Medicare PECOS PAC ID | 0840242467 |
|---|---|
| Medicare Enrollment ID | O20100929000108 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881629012 | NPI | - | NPPES |
| 091173 | Other | HIGHMARK BLUE SHIELD | |
| 1007288260005 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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