Healthcare Provider Details

I. General information

NPI: 1578848578
Provider Name (Legal Business Name): AIDS CARE GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2011
Last Update Date: 10/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

907 CHESTER PIKE
SHARON HILL PA
19079-1411
US

IV. Provider business mailing address

2304 EDGMONT AVE
CHESTER PA
19013-5038
US

V. Phone/Fax

Practice location:
  • Phone: 610-583-1177
  • Fax:
Mailing address:
  • Phone: 610-872-9101
  • Fax: 610-872-9103

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number StatePA

VIII. Authorized Official

Name: DR. HOWELL STRAUSS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 610-389-2301