MEDICARE: FOOT HEALTH CENTERS, P.A.

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	213E00000X	Podiatrist

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
2	0060618000	OTHER	PA	KEYSTONE HEALTH PLAN EAST
3	20770	OTHER	PA	HEALTH PARTNERS
4	31881	OTHER	PA	KEYSTONE MERCY

General Provider Information

NPI Number	:	1952415911
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOOT HEALTH CENTERS, P.A.

Provider Business Mailing Address
First Line	:	52 BERLIN RD
Second Line	:	SUITE 5000
City	:	CHERRY HILL
State	:	NJ
Zip	:	08034-3574
Country	:	US
Telephone Number	:	856-795-1003
Fax Number	:	856-795-5994

Provider Business Practice Location Address
First Line	:	6111 LANSDOWNE AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19151-3933
Country	:	US
Telephone Number	:	215-473-7765
Fax Number	:	856-795-5994

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	JANINE COTTRILL
Credential	:
Telephone Number	:	856-795-1003

Provider Enumeration Date	:	08/18/2006
Last Update Date	:	12/14/2007

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