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NPI Code Detail

MEDICARE: THE BEHAVIORAL WELLNESS CENTER AT GIRARD

MEDICARE: THE BEHAVIORAL WELLNESS CENTER AT GIRARD
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
13336I0012XInstitutional PharmacyHP418185LPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
13923047OTHERNCPDP PROVIDER IDENTIFICATION NUMBER
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1306975115
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE BEHAVIORAL WELLNESS CENTER AT GIRARD
Provider Business Mailing Address
First Line : 801 W GIRARD AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19122-4212
Country : US
Telephone Number : 215-787-2460
Fax Number : 215-787-2321
Provider Business Practice Location Address
First Line : 801 W GIRARD AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19122-4212
Country : US
Telephone Number : 215-787-2460
Fax Number : 215-787-2321
Authorized Official
Title or Position : DIRECTOR OF PHARMACY
Name : TIM CROWLEY
Credential :
Telephone Number : 215-787-9359
Provider Enumeration Date : 03/05/2007
Last Update Date : 08/03/2022

Similar Medicare Providers

1275534018 — ILIA NIKHINSON MD
Practice Location Address:
801 W GIRARD AVE
PHILADELPHIA, PA
19122-4212
Practice Phone: 215-787-2000
Practice Fax:
1053312272 — GIRISH SHAH MD
Practice Location Address:
801 W GIRARD AVE
PHILADELPHIA, PA
19122-4212
Practice Phone: 215-787-2383
Practice Fax: 215-787-4374
1194726323 — NORTH PHILADELPHIA HEALTH SYSTEM
Practice Location Address:
801 W GIRARD AVE
PHILADELPHIA, PA
19122-4212
Practice Phone: 215-787-2000
Practice Fax: 215-787-6990
1871581868 — JAVED JOY MD
Practice Location Address:
801 W GIRARD AVE
PHILADELPHIA, PA
19122-4212
Practice Phone: 215-787-2573
Practice Fax:
1598798928 — THE BEHAVIORAL WELLNESS CENTER AT GIRARD
Practice Location Address:
801 W GIRARD AVE
PHILADELPHIA, PA
19122-4212
Practice Phone: 215-787-2000
Practice Fax: 215-787-2115
1164445128 — NORTH PHILADELPHIA HEALTH SYSTEM
Practice Location Address:
801 W GIRARD AVE
PHILADELPHIA, PA
19122-4212
Practice Phone: 215-787-2000
Practice Fax: 215-787-2115

Directions to “THE BEHAVIORAL WELLNESS CENTER AT GIRARD ” Practice Location

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