Healthcare Provider Details

I. General information

NPI: 1295820256
Provider Name (Legal Business Name): CHILDRENS HEALTH CARE ASSOCIATES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 02/06/2025
Certification Date: 02/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3401 CIVIC CENTER BLVD CHILDREN'S HOSPITAL OF PHILADELPHIA
PHILADELPHIA PA
19104-4319
US

IV. Provider business mailing address

2929 ARCH ST FL 12
PHILADELPHIA PA
19104-2857
US

V. Phone/Fax

Practice location:
  • Phone: 215-590-1000
  • Fax: 267-425-9299
Mailing address:
  • Phone: 267-425-9408
  • Fax: 267-443-1341

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0216X
TaxonomyPediatric Rheumatology Physician
License Number
License Number State

VIII. Authorized Official

Name: CHERISH FLOWERS
Title or Position: ENROLLMENT MANAGER
Credential:
Phone: 267-425-9408