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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
1207Q00000XFamily Medicine Physician
2207R00000XInternal Medicine Physician
3207V00000XObstetrics & Gynecology Physician
4208000000XPediatrics Physician
5213E00000XPodiatrist
6176B00000XMidwife
7261Q00000XClinic/Center
8261QF0400XFederally Qualified Health Center (FQHC)

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1417902362
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 : 800 WASHINGTON AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19147-4717
Country : US
Telephone Number : 215-339-5100
Fax Number : 215-454-6814
Authorized Official
Title or Position : PROVIDER ENROLLMENT SPEC
Name : D TINA SMITH
Credential :
Telephone Number : 215-925-2400
Provider Enumeration Date : 05/22/2006
Last Update Date : 03/16/2017

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

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