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General NPI Number Information
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NPI Number | 1023171303
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Entity Type | Organization
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Legal Business Name | GREATER PHILADELPHIA HEALTH ACTION, INC.
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Dates
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Enumeration Date | 12/18/2006
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Last Update Date | 10/02/2009
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Provider Practice Location Address
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Address Line | 2520 SNYDER AVE
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City | PHILA
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State | PA
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Zip | 19145-3101
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Country | US
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Telephone | 215-755-6866
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Fax |
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Provider Business Mailing Address
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Address Line | 432 N 6TH ST
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City | PHILA
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State | PA
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Zip | 19123-4004
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Country | US
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Telephone | 215-925-2400
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | RONALD HEIGLER
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Credential |
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Telephone | 215-925-2400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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