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General NPI Number Information
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NPI Number | 1194136705
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Entity Type | Organization
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Legal Business Name | FEDERAL BUREAU OF PRISONS
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Dates
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Enumeration Date | 05/16/2014
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Last Update Date | 05/16/2014
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Provider Practice Location Address
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Address Line | 700 ARCH ST
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City | PHILADELPHIA
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State | PA
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Zip | 19106-1548
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Country | US
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Telephone | 215-521-4091
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Fax | 215-521-4083
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Provider Business Mailing Address
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Address Line | 700 ARCH ST
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City | PHILADELPHIA
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State | PA
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Zip | 19106-1548
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Country | US
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Telephone | 215-521-4091
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Fax | 215-521-4083
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Authorized Official
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Title or Position | ASSISTANT HSA
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Name | MR. BRIAN MURPHY
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Credential |
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Telephone | 215-521-4091
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2400X
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Taxonomy Name | Prison Health Clinic/Center
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License Number |
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License Number State |
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