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NPI Code Detail

MEDICARE: KIPP WEST PHILADELPHIA CHARTER SCHOOL

MEDICARE: KIPP WEST PHILADELPHIA CHARTER SCHOOL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251300000XLocal Education Agency (LEA)

General Provider Information

NPI Number : 1285178293
Entity Type Code : Organization
Provider Name (Legal Business Name) : KIPP WEST PHILADELPHIA CHARTER SCHOOL
Provider Business Mailing Address
First Line : 5900 BALTIMORE AVE
Second Line : 1ST FLOOR
City : PHILADELPHIA
State : PA
Zip : 19143-3129
Country : US
Telephone Number : 267-787-5700
Fax Number : 267-787-5711
Provider Business Practice Location Address
First Line : 5900 BALTIMORE AVE
Second Line : 1ST FLOOR
City : PHILADELPHIA
State : PA
Zip : 19143-3129
Country : US
Telephone Number : 267-787-5700
Fax Number : 267-787-5711
Authorized Official
Title or Position : CEO
Name : DIANA FILO
Credential :
Telephone Number : 215-901-6248
Provider Enumeration Date : 12/09/2016
Last Update Date : 12/09/2016

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Directions to “KIPP WEST PHILADELPHIA CHARTER SCHOOL ” Practice Location

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