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General NPI Number Information
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NPI Number | 1841802592
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Entity Type | Organization
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Legal Business Name | COMMUNITY HEALTH & WELLNESS SERVICES, INC.
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Dates
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Enumeration Date | 08/22/2020
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Last Update Date | 05/25/2021
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Provider Practice Location Address
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Address Line | COMMUNITY HEALTH & WELLNESS SERVICES INC 2600 SOUTHAMPTON RD
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City | PHILADELPHIA
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State | PA
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Zip | 19116
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Country | US
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Telephone | 215-287-7260
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Fax | 215-550-5101
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Provider Business Mailing Address
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Address Line | 312 MEMORIAL PARK DR
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City | SPRINGFIELD
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State | PA
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Zip | 19064-1714
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Country | US
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Telephone | 215-287-7260
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. YAHAYA EHIGIE ENAKHIMION
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Credential | CRNP
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Telephone | 215-392-2961
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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