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General NPI Number Information
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NPI Number | 1578861605
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Entity Type | Organization
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Legal Business Name | PHILADELPHIA DEPT. OF PUBLIC HEALTH
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Dates
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Enumeration Date | 03/15/2011
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Last Update Date | 04/03/2014
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Provider Practice Location Address
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Address Line | 500 S BROAD ST SECOND FLOOR
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City | PHILADELPHIA
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State | PA
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Zip | 19146-1613
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Country | US
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Telephone | 215-685-6741
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Fax | 215-545-8362
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Provider Business Mailing Address
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Address Line | 500 S BROAD ST SECOND FLOOR
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City | PHILADELPHIA
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State | PA
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Zip | 19146-1613
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Country | US
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Telephone | 215-685-6741
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Fax | 215-545-8362
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Authorized Official
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Title or Position | DIRECTOR, DIV. OF DISEASE CONTROL
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Name | DR. CAROLINE JOHNSON
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Credential | M.D.
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Telephone | 215-685-6741
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP0905X
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Taxonomy Name | State or Local Public Health Clinic/Center
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License Number |
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License Number State |
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