MEDICARE: SCHOOL DISTRICT OF PHILADELPHIA

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
1	251300000X	Local Education Agency (LEA)		PA

Other Identifiers

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

General Provider Information

NPI Number	:	1447307517
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SCHOOL DISTRICT OF PHILADELPHIA

Provider Business Mailing Address
First Line	:	440 N BROAD ST
Second Line	:	3RD FLOOR - SUITE 323
City	:	PHILADELPHIA
State	:	PA
Zip	:	19130-4015
Country	:	US
Telephone Number	:	215-400-4580
Fax Number	:	215-400-4582

Provider Business Practice Location Address
First Line	:	440 N BROAD ST
Second Line	:	3RD FLOOR - SUITE 323
City	:	PHILADELPHIA
State	:	PA
Zip	:	19130-4015
Country	:	US
Telephone Number	:	215-400-4580
Fax Number	:	215-400-4582

Authorized Official
Title or Position	:	FIN SVCS DIR, ACCESS PROGRAM
Name	:	MICHELLE OVINGTON
Credential	:
Telephone Number	:	215-400-5476

Provider Enumeration Date	:	01/04/2007
Last Update Date	:	01/26/2021

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Directions to “SCHOOL DISTRICT OF PHILADELPHIA ” Practice Location

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