=====================================================
General NPI Number Information
=====================================================
NPI Number | 1962597500
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PLANNED PARENTHOOD KEYSTONE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/03/2006
-----------------------------------------------------
Last Update Date | 10/03/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 29 N 9TH ST
-----------------------------------------------------
City | ALLENTOWN
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 18101-1102
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-871-7200
-----------------------------------------------------
Fax | 610-871-6210
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1068
-----------------------------------------------------
City | BENSALEM
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19020-5068
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-481-0481
-----------------------------------------------------
Fax | 610-871-6210
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR OF HEALTH SERVICES & SYSTE
-----------------------------------------------------
Name | ALICIA HAMPTON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 610-709-6074
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | MD056874L
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 261QA0005X
-----------------------------------------------------
Taxonomy Name | Ambulatory Family Planning Facility
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 261QF0050X
-----------------------------------------------------
Taxonomy Name | Non-Surgical Family Planning Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 261Q00000X
-----------------------------------------------------
Taxonomy Name | Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------