Healthcare Provider Details

I. General information

NPI: 1275151607
Provider Name (Legal Business Name): GREATER PHILADELPHIA HEALTH ACTION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2020
Last Update Date: 07/29/2025
Certification Date: 07/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1717 W ALLEGHENY AVE
PHILADELPHIA PA
19132-1606
US

IV. Provider business mailing address

1401 S 31ST ST FL 2
PHILADELPHIA PA
19146-3506
US

V. Phone/Fax

Practice location:
  • Phone: 215-925-2400
  • Fax:
Mailing address:
  • Phone: 215-925-2400
  • Fax: 215-925-4201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: CELESTE JOHNS
Title or Position: DIRECTOR
Credential:
Phone: 215-925-2400