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NPI Code Detail

MEDICARE: GREATER PHILADELPHIA HEALTH ACTION INC.

MEDICARE: GREATER PHILADELPHIA HEALTH ACTION INC.
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
1261QF0400XFederally Qualified Health Center (FQHC)
2261QD0000XDental Clinic/Center

General Provider Information

NPI Number : 1326493321
Entity Type Code : Organization
Provider Name (Legal Business Name) : GREATER PHILADELPHIA HEALTH ACTION INC.
Provider Business Mailing Address
First Line : 1401 S 31ST ST
Second Line : 2ND FLOOR
City : PHILADELPHIA
State : PA
Zip : 19146-3506
Country : US
Telephone Number : 215-925-2400
Fax Number : 215-925-9162
Provider Business Practice Location Address
First Line : 3223 N BROAD ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19140-5007
Country : US
Telephone Number : 215-226-3789
Fax Number : 215-226-3794
Authorized Official
Title or Position : PROVIDER ENROLLMENT SPEC.
Name : MRS. D TINA SMITH
Credential :
Telephone Number : 215-925-2400
Provider Enumeration Date : 04/27/2016
Last Update Date : 03/15/2017

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Directions to “GREATER PHILADELPHIA HEALTH ACTION INC. ” Practice Location

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