MEDICARE: NATIONAL NURSING CENTERS CONSORTIUM - PHMC

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	163W00000X	Registered Nurse

General Provider Information

NPI Number	:	1356488050
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NATIONAL NURSING CENTERS CONSORTIUM - PHMC

Provider Business Mailing Address
First Line	:	4601 MARKET ST FL 1
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19139-4636
Country	:	US
Telephone Number	:	215-985-6233
Fax Number	:	267-765-2360

Provider Business Practice Location Address
First Line	:	4601 MARKET ST FL 1
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19139-4636
Country	:	US
Telephone Number	:	215-985-6233
Fax Number	:	267-765-2360

Authorized Official
Title or Position	:	BILLING COORDINATOR
Name	:	CARLA WALKER
Credential	:
Telephone Number	:	215-985-6233

Provider Enumeration Date	:	01/31/2007
Last Update Date	:	01/01/2025

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