MEDICARE: INGLIS FOUNDATION

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	251B00000X	Case Management Agency

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	:	1912231242
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INGLIS FOUNDATION

Provider Business Mailing Address
First Line	:	2600 BELMONT AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19131-2713
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2600 BELMONT AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19131-2713
Country	:	US
Telephone Number	:	215-878-5600
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT & CEO
Name	:	DYANN ROTH
Credential	:
Telephone Number	:	215-581-0700

Provider Enumeration Date	:	09/18/2009
Last Update Date	:	09/13/2022

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Directions to “INGLIS FOUNDATION ” Practice Location

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