MEDICARE: MAST COMMUNITY CHARTER SCHOOL II

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251300000X	Local Education Agency (LEA)

General Provider Information

NPI Number	:	1275985988
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAST COMMUNITY CHARTER SCHOOL II

Provider Business Mailing Address
First Line	:	6238 RISING SUN AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19111-5621
Country	:	US
Telephone Number	:	267-348-1100
Fax Number	:	267-348-1217

Provider Business Practice Location Address
First Line	:	6238 RISING SUN AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19111-5621
Country	:	US
Telephone Number	:	267-348-1100
Fax Number	:	267-348-1217

Authorized Official
Title or Position	:	CEO
Name	:	MR. JOHN F SWOYER III
Credential	:	CEO
Telephone Number	:	267-348-1100

Provider Enumeration Date	:	07/06/2016
Last Update Date	:	08/16/2016

Similar Medicare Providers

1952919771 — CAITLIN WETZLER CRNP
Practice Location Address:

2028 RITTENHOUSE SQ APT 103
PHILADELPHIA, PA
19103-5621

Practice Phone: 610-574-9363
Practice Fax:

1851000509 — U R A BLESSING HOMECARE LLC
Practice Location Address:

5621 N 15TH ST
PHILADELPHIA, PA
19141-2311

Practice Phone: 267-234-8273
Practice Fax:

1336458322 — DR. SRIKRISHNA VARUN MALAYALA MD
Practice Location Address:

7600 CENTRAL AVE , 2ND FL FOUNDER'S BLDG
PHILADELPHIA, PA
19111-2442

Practice Phone: 215-728-2000
Practice Fax: 215-214-4119

1407612344 — ADDICTION CONSULTANTS OF PENNSYLVANIA LLC
Practice Location Address:

7600 CENTRAL AVE
PHILADELPHIA, PA
19111-2442

Practice Phone: 304-951-3599
Practice Fax:

1023388824 — JUSTIN EPPLEY DNP, AGPCNP-BC
Practice Location Address:

333 COTTMAN AVE
PHILADELPHIA, PA
19111-2497

Practice Phone: 215-728-4300
Practice Fax:

1821782434 — MS. LYDIA HEARN PA-C
Practice Location Address:

333 COTTMAN AVE
PHILADELPHIA, PA
19111-2497

Practice Phone: 215-728-8626
Practice Fax: 215-728-2773

Directions to “MAST COMMUNITY CHARTER SCHOOL II ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.