MEDICARE: GENERAL HEALTHCARE 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
1	251S00000X	Community/Behavioral Health Agency	26663756	PA

General Provider Information

NPI Number	:	1851517593
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GENERAL HEALTHCARE INC.

Provider Business Mailing Address
First Line	:	142 N HOBART ST
Second Line	:	4511 WALNUT STREET APT. 215
City	:	PHILADELPHIA
State	:	PA
Zip	:	19139-2431
Country	:	US
Telephone Number	:	215-476-5010
Fax Number	:

Provider Business Practice Location Address
First Line	:	142 N HOBART ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19139-2431
Country	:	US
Telephone Number	:	215-476-5010
Fax Number	:

Authorized Official
Title or Position	:	PHARMACY T00ECHNICIAN
Name	:	MISS SHANIKA S. WHITE
Credential	:	NATIONAL CERTIFIED
Telephone Number	:	800-879-4471

Provider Enumeration Date	:	04/18/2007
Last Update Date	:	08/22/2020

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