Healthcare Provider Details

I. General information

NPI: 1508020967
Provider Name (Legal Business Name): KENSINGTON HOSPITAL- FAMILY PLANNING CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2008
Last Update Date: 07/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

136 DIAMOND ST
PHILADELPHIA PA
19122-1721
US

IV. Provider business mailing address

136 DIAMOND ST
PHILADELPHIA PA
19122-1721
US

V. Phone/Fax

Practice location:
  • Phone: 215-426-8100
  • Fax: 215-965-2344
Mailing address:
  • Phone: 215-426-8100
  • Fax: 215-965-2344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0005X
TaxonomyAmbulatory Family Planning Facility
License Number111101
License Number StatePA

VIII. Authorized Official

Name: MS. EILEEN; HAUSE
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 215-426-8100