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General NPI Number Information
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NPI Number | 1720134240
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Entity Type | Organization
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Legal Business Name | PUBLIC HEALTH MANAGEMENT CORP
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Dates
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Enumeration Date | 01/26/2007
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Last Update Date | 01/25/2013
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Provider Practice Location Address
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Address Line | 1200 CALLOWHILL STREET
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City | PHILADELPHIA
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State | PA
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Zip | 19123
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Country | US
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Telephone | 215-923-0218
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Fax | 215-923-5650
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Provider Business Mailing Address
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Address Line | 260 S BROAD STREET 18TH FLOOR
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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 | 215-985-2500
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Fax | 215-731-2049
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. RICHARD J COHEN
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Credential | PHD
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Telephone | 215-985-2501
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 807364
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License Number State | PA
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