MEDICARE: WILLS COMMUNITY SURGICAL SERVICES OF CENTER CITY

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	261Q00000X	Clinic/Center	261QA1903X	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	001580	OTHER	PA	BC

General Provider Information

NPI Number	:	1568461150
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WILLS COMMUNITY SURGICAL SERVICES OF CENTER CITY

Provider Business Mailing Address
First Line	:	WILLS COMMUNITY SURGICAL SERVICES OF CENTER CITY
Second Line	:	840 WALNUT STREET, SUITE 700
City	:	PHILADELPHIA
State	:	PA
Zip	:	19107-5109
Country	:	US
Telephone Number	:	215-928-3100
Fax Number	:	215-928-3006

Provider Business Practice Location Address
First Line	:	WILLS COMMUNITY SURGICAL SERVICES OF CENTER CITY
Second Line	:	840 WALNUT STREET, SUITE 700
City	:	PHILADELPHIA
State	:	PA
Zip	:	19107-5109
Country	:	US
Telephone Number	:	215-928-3100
Fax Number	:	215-928-3006

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JOSEPH P BILSON
Credential	:
Telephone Number	:	215-440-3152

Provider Enumeration Date	:	07/18/2005
Last Update Date	:	08/22/2020

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Directions to “WILLS COMMUNITY SURGICAL SERVICES OF CENTER CITY ” Practice Location

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