Healthcare Provider Details

I. General information

NPI: 1063655231
Provider Name (Legal Business Name): PLANNED PARENTHOOD SOUTHEASTERN PENNSYLVANIA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2009
Last Update Date: 04/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 S WAYNE ST
WEST CHESTER PA
19382-2817
US

IV. Provider business mailing address

1144 LOCUST ST
PHILADELPHIA PA
19107-6734
US

V. Phone/Fax

Practice location:
  • Phone: 610-692-1770
  • Fax: 610-241-0010
Mailing address:
  • Phone: 215-351-5500
  • Fax: 251-351-5595

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QA0005X
TaxonomyAmbulatory Family Planning Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: VERA BAILEY
Title or Position: CFO
Credential:
Phone: 215-351-5536