Healthcare Provider Details

I. General information

NPI: 1316166515
Provider Name (Legal Business Name): FRIENDS HOSPICE PROJECT OF PHILADELPHIA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2007
Last Update Date: 03/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

706 W GIRARD AVE
PHILADELPHIA PA
19123-1313
US

IV. Provider business mailing address

706 W GIRARD AVE
PHILADELPHIA PA
19123-1313
US

V. Phone/Fax

Practice location:
  • Phone: 215-925-6848
  • Fax: 215-925-6846
Mailing address:
  • Phone: 215-925-6848
  • Fax: 215-925-6846

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number16941601
License Number StatePA

VIII. Authorized Official

Name: TYLAANN BURGER
Title or Position: EXECUTIVE DIRECTOR
Credential: RN
Phone: 215-925-6848