1891837084 NPI number — PLANNED PARENTHOOD SOUTHEASTERN PENNSYLVANIA

Table of content: (NPI 1891837084)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891837084 NPI number — PLANNED PARENTHOOD SOUTHEASTERN PENNSYLVANIA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PLANNED PARENTHOOD SOUTHEASTERN PENNSYLVANIA
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:
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:
1891837084
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1144 LOCUST ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PHILADELPHIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19107-6734
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-351-5500
Provider Business Mailing Address Fax Number:
215-351-5595

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
19 LINDENWOLD AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AMBLER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19002-4420
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-351-5500
Provider Business Practice Location Address Fax Number:
215-351-5595
Provider Enumeration Date:
02/13/2007

Additional Information

Authorized Official

Authorized Official Last Name:
BAILEY
Authorized Official First Name:
VERA
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
215-351-5536

Provider Taxonomy Codes

  • Taxonomy code: 207VG0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 261QA0005X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 261QM1300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 3336C0002X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

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

  • Identifier: 0060242000 . This is a "IBC PROVIDER #" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 156525 . This is a "PA BC-BS PROVIDER #" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1007730530002 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 5066359 . This is a "AETNA PROVIDER #" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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