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NPI Code Detail

MEDICARE: DELAWARE VALLEY COMMUNITY HEALTH, INC.

MEDICARE: DELAWARE VALLEY COMMUNITY HEALTH, 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
1261QF0400XFederally Qualified Health Center (FQHC)
23336C0003XCommunity/Retail Pharmacy

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1962206359
Entity Type Code : Organization
Provider Name (Legal Business Name) : DELAWARE VALLEY COMMUNITY HEALTH, INC.
Provider Business Mailing Address
First Line : 1412-22 FAIRMOUNT AVENUE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19130-2908
Country : US
Telephone Number : 215-684-5344
Fax Number : 215-232-4093
Provider Business Practice Location Address
First Line : 401 W ALLEGHENY AVE STE 200
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19133-3644
Country : US
Telephone Number : 215-207-0528
Fax Number : 267-758-6205
Authorized Official
Title or Position : PRESIDENT & CEO
Name : BRENDA ROBLES COOKE
Credential :
Telephone Number : 215-684-5344
Provider Enumeration Date : 04/03/2025
Last Update Date : 03/05/2026

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Practice Location Address:
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Practice Location Address:
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1538124482 — DR. MICHELLE J HUDSON DDS
Practice Location Address:
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Directions to “DELAWARE VALLEY COMMUNITY HEALTH, INC. ” Practice Location

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