MEDICARE: PLANNED PARENTHOOD SOUTHEASTERN PENNSYLVANIA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	207VG0400X	Gynecology Physician
2	261QM1300X	Multi-Specialty Clinic/Center
3	3336C0002X	Clinic Pharmacy
4	261QA0005X	Ambulatory Family Planning Facility

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0060242000	OTHER	PA	IBC PROVIDER #
2	5066359	OTHER	PA	AETNA PROVIDER#
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	156525	OTHER	PA	BC-BS PROVIDER #

General Provider Information

NPI Number	:	1700928611
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PLANNED PARENTHOOD SOUTHEASTERN PENNSYLVANIA

Provider Business Mailing Address
First Line	:	1144 LOCUST ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19107-6734
Country	:	US
Telephone Number	:	215-351-5500
Fax Number	:	215-351-5595

Provider Business Practice Location Address
First Line	:	1211 CHESTNUT ST
Second Line	:	SUITE 405
City	:	PHILADELPHIA
State	:	PA
Zip	:	19107-4103
Country	:	US
Telephone Number	:	215-351-5500
Fax Number	:	215-351-5595

Authorized Official
Title or Position	:	CFO
Name	:	VERA BAILEY
Credential	:
Telephone Number	:	215-351-5536

Provider Enumeration Date	:	02/14/2007
Last Update Date	:	08/13/2014

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Directions to “PLANNED PARENTHOOD SOUTHEASTERN PENNSYLVANIA ” 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.

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