MEDICARE: VINE STREET MEDICAL AND ASSOCIATES

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	111N00000X	Chiropractor	DC010067	PA

General Provider Information

NPI Number	:	1487181699
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VINE STREET MEDICAL AND ASSOCIATES

Provider Business Mailing Address
First Line	:	6323 VINE ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19139-1032
Country	:	US
Telephone Number	:	267-292-5638
Fax Number	:

Provider Business Practice Location Address
First Line	:	6323 VINE ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19139-1032
Country	:	US
Telephone Number	:	267-292-5638
Fax Number	:

Authorized Official
Title or Position	:	ADMIN
Name	:	SHARI JOHNSON
Credential	:	HA
Telephone Number	:	267-292-5638

Provider Enumeration Date	:	05/18/2017
Last Update Date	:	07/21/2022

Similar Medicare Providers

1932198157 — MERCY MANAGEMENT OF SOUTHEASTERN PENNSYLVANIA
Practice Location Address:

6323 VINE ST
PHILADELPHIA, PA
19139-1032

Practice Phone: 215-748-8303
Practice Fax: 215-748-8660

1861921389 — VINE STREET MEDICAL AND ASSOCIATES
Practice Location Address:

6323 VINE ST
PHILADELPHIA, PA
19139-1032

Practice Phone: 267-292-5638
Practice Fax: 267-292-5648

1851414759 — NEW GIRARD PHARMACY
Practice Location Address:

4000 W GIRARD AVE
PHILADELPHIA, PA
19104-1032

Practice Phone: 215-386-1594
Practice Fax:

1558790899 — JENNIFER LADJA
Practice Location Address:

1311 LOMBARD ST APT 502
PHILADELPHIA, PA
19147-1032

Practice Phone: 732-567-6114
Practice Fax:

1659702371 — MS. KATIE LEE GREBLE MA ATR-BC LPC
Practice Location Address:

2801 GRANT AVE
PHILADELPHIA, PA
19114-1032

Practice Phone: 215-695-4286
Practice Fax:

1942600044 — STEPHEN SMITH
Practice Location Address:

6504 WALNUT PARK DR
PHILADELPHIA, PA
19120-1032

Practice Phone: 267-283-5571
Practice Fax:

Directions to “VINE STREET MEDICAL AND ASSOCIATES ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.