Healthcare Provider Details
I. General information
NPI: 1821444209
Provider Name (Legal Business Name): FOX SUBACUTE AT SOUTH PHILADELPHIA LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/04/2016
Last Update Date: 11/11/2025
Certification Date: 11/11/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1930 SOUTH BROAD STREET
PHILADELPHIA PA
19145
US
IV. Provider business mailing address
350 W MAIN ST STE 101
TRAPPE PA
19426-1989
US
V. Phone/Fax
- Phone: 484-342-4153
- Fax: 610-862-0614
- Phone: 484-342-4153
- Fax: 610-862-0614
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JULIE
BASCOU
Title or Position: NHA
Credential:
Phone: 215-709-4000