Healthcare Provider Details

I. General information

NPI: 1447301122
Provider Name (Legal Business Name): PLANNED PARENTHOOD SOUTHEASTERN PENNSYLVANIA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 09/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1144 LOCUST ST
PHILADELPHIA PA
19107-6734
US

IV. Provider business mailing address

1144 LOCUST ST
PHILADELPHIA PA
19107-6734
US

V. Phone/Fax

Practice location:
  • Phone: 215-351-5500
  • Fax: 215-351-5595
Mailing address:
  • Phone: 215-351-5500
  • Fax: 215-351-5595

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA0005X
TaxonomyAmbulatory Family Planning Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. VERA BAILEY
Title or Position: CFO
Credential:
Phone: 215-351-5536