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General NPI Number Information
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NPI Number | 1477830305
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Entity Type | Organization
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Legal Business Name | MORAVIA HEALTH NETWORK, LLC
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Dates
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Enumeration Date | 11/06/2011
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Last Update Date | 06/26/2018
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Provider Practice Location Address
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Address Line | 1500 WALNUT ST STE 1900
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City | PHILADELPHIA
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State | PA
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Zip | 19102
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Country | US
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Telephone | 215-717-8650
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Fax | 215-717-7839
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Provider Business Mailing Address
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Address Line | 1500 WALNUT ST STE 1900
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City | PHILADELPHIA
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State | PA
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Zip | 19102-3509
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Country | US
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Telephone | 215-717-8650
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Fax | 215-717-7839
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. C. FRANK IGWE
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Credential |
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Telephone | 215-717-8650
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 32093601
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License Number State | PA
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