MEDICARE: SPECTRUM HEALTH SERVICES, INC.

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	261QF0400X	Federally Qualified Health Center (FQHC)

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
2	091193	OTHER	PA	HIGHMARK BLUE SHIELD

General Provider Information

NPI Number	:	1689045437
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPECTRUM HEALTH SERVICES, INC.

Provider Business Mailing Address
First Line	:	5201 HAVERFORD AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19139-1401
Country	:	US
Telephone Number	:	215-471-2761
Fax Number	:	215-472-6093

Provider Business Practice Location Address
First Line	:	1325 S 33RD ST
Second Line	:	3RD FLOOR
City	:	PHILADELPHIA
State	:	PA
Zip	:	19146-3303
Country	:	US
Telephone Number	:	215-471-2761
Fax Number	:	215-472-6093

Authorized Official
Title or Position	:	PRESIDENT AND CEO
Name	:	MISS VERONICA HILL-MILBOURNE
Credential	:
Telephone Number	:	215-471-2761

Provider Enumeration Date	:	10/19/2015
Last Update Date	:	05/19/2026

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Directions to “SPECTRUM HEALTH SERVICES, INC. ” Practice Location

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