MEDICARE: FIRST PHILADELPHIA CHARTER SCHOOL

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	:	1508871229
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIRST PHILADELPHIA CHARTER SCHOOL

Provider Business Mailing Address
First Line	:	4300 TACONY ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19124-4134
Country	:	US
Telephone Number	:	215-743-3100
Fax Number	:	215-743-9877

Provider Business Practice Location Address
First Line	:	4300 TACONY ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19124-4134
Country	:	US
Telephone Number	:	215-743-3100
Fax Number	:	215-743-9877

Authorized Official
Title or Position	:	PRINCIPAL - HEAD OF SCHOOL
Name	:	MRS. STACEY C CLARKE
Credential	:	MA.ED.
Telephone Number	:	215-743-3100

Provider Enumeration Date	:	07/30/2006
Last Update Date	:	08/22/2020

Similar Medicare Providers

1346683281 — MRS. KATHLEEN MARIE BRESLINFOULKROD COTA/L, B.S.
Practice Location Address:

4300 TACONY ST
PHILADELPHIA, PA
19124-4134

Practice Phone: 215-743-3100
Practice Fax:

1164412144 — DR. JENNIFER LEIGH PARISH M.D.
Practice Location Address:

1760 MARKET ST , STE 301
PHILADELPHIA, PA
19103-4134

Practice Phone: 215-563-8333
Practice Fax: 215-563-3044

1104917681 — MR. WILLAIM COFFEY LCSW
Practice Location Address:

1760 MARKET ST , SUITE 700
PHILADELPHIA, PA
19103-4134

Practice Phone: 215-575-9140
Practice Fax:

1124113873 — DR. JANET L ETZI PSYD
Practice Location Address:

18 DRUIM MOIR LN
PHILADELPHIA, PA
19118-4134

Practice Phone: 215-264-4625
Practice Fax:

1356488720 — LAWRENCE CHARLES PARISH MD
Practice Location Address:

1760 MARKET ST , SUITE 301
PHILADELPHIA, PA
19103-4134

Practice Phone: 215-563-8333
Practice Fax: 215-563-3044

1801924584 — RESOURCES FOR HUMAN DEVELOPMENT
Practice Location Address:

10825 E KESWICK RD
PHILADELPHIA, PA
19154-4134

Practice Phone: 215-848-1947
Practice Fax: 215-848-1601

Directions to “FIRST PHILADELPHIA CHARTER SCHOOL ” 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.