1356893085 NPI number — PUBLIC HEALTH MANAGMENT CORPORATION (PHMC)

Table of content: (NPI 1356893085)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356893085 NPI number — PUBLIC HEALTH MANAGMENT CORPORATION (PHMC)

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PUBLIC HEALTH MANAGMENT CORPORATION (PHMC)
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1356893085
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/28/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1500 MARKET STREET
Provider Second Line Business Mailing Address:
LM500, LOWER MEZZANINE, WEST TOWER
Provider Business Mailing Address City Name:
PHILADELPHIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19102-5000
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-985-2500
Provider Business Mailing Address Fax Number:
215-985-2550

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2301 E ALLEGHENY AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19134-4427
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-731-2402
Provider Business Practice Location Address Fax Number:
267-592-4123
Provider Enumeration Date:
10/28/2016

Additional Information

Authorized Official

Authorized Official Last Name:
WUSSOW
Authorized Official First Name:
JAY
Authorized Official Middle Name:
MILTON
Authorized Official Title or Position:
DIR OF FIN & REG AFFIRS FOR BHS
Authorized Official Telephone Number:
215-985-2575

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  807439 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com