MEDICARE: STAPELEY HALL

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	314000000X	Skilled Nursing Facility	455502	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295753978
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STAPELEY HALL

Provider Business Mailing Address
First Line	:	6300 GREENE ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19144-2596
Country	:	US
Telephone Number	:	215-844-0700
Fax Number	:	215-991-7124

Provider Business Practice Location Address
First Line	:	6300 GREENE ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19144-2510
Country	:	US
Telephone Number	:	215-844-0700
Fax Number	:	215-991-7124

Authorized Official
Title or Position	:	CORPORATE DIRECTOR OF RCM
Name	:	RONNIE CONNER
Credential	:
Telephone Number	:	267-885-6232

Provider Enumeration Date	:	07/18/2006
Last Update Date	:	05/28/2026

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Directions to “STAPELEY HALL ” Practice Location

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