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NPI Code Detail

MEDICARE: PENNSYLVANIA SUPPORTS COORDINATION AGENCY

MEDICARE: PENNSYLVANIA SUPPORTS COORDINATION AGENCY
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
1251B00000XCase Management Agency

General Provider Information

NPI Number : 1285000356
Entity Type Code : Organization
Provider Name (Legal Business Name) : PENNSYLVANIA SUPPORTS COORDINATION AGENCY
Provider Business Mailing Address
First Line : 218 E WISTER ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19144-1827
Country : US
Telephone Number : 215-929-1305
Fax Number : 215-843-6830
Provider Business Practice Location Address
First Line : 218 E WISTER ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19144-1827
Country : US
Telephone Number : 215-929-1305
Fax Number : 215-843-6830
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MR. EARLSON SATINE
Credential : B.S.
Telephone Number : 215-929-1305
Provider Enumeration Date : 08/12/2015
Last Update Date : 08/12/2015

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Directions to “PENNSYLVANIA SUPPORTS COORDINATION AGENCY ” Practice Location

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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.