Healthcare Provider Details

I. General information

NPI: 1831258045
Provider Name (Legal Business Name): CITY OF PHILADELPHIA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 01/12/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 W GIRARD AVE
PHILADELPHIA PA
19130-1400
US

IV. Provider business mailing address

2100 W GIRARD AVE
PHILADELPHIA PA
19130-1400
US

V. Phone/Fax

Practice location:
  • Phone: 215-685-0800
  • Fax: 215-685-0975
Mailing address:
  • Phone: 215-685-0800
  • Fax: 215-685-0975

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number163902
License Number StatePA

VIII. Authorized Official

Name: JAMES SCANNAPIECO
Title or Position: ASSOCIATE ADMINISTRATOR, FINANCE
Credential:
Phone: 215-685-0800