DEDICATED PENNSYLVANIA HOLDING LLC NPI 1023655602

NPI Information

DEDICATED PENNSYLVANIA HOLDING, LLC is a non pharmacy dispensing site in Philadelphia, PA. The provider is a site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) DEDICATED PENNSYLVANIA HOLDING, LLC NPI is 1023655602. The provider is registered as an organization entity type.
The provider Is Doing Business As Dedicated Senior Medical Center South Philadelphia.

The provider's business location address is:

330 W OREGON AVE # 170
PHILADELPHIA, PA
ZIP 19148-723
Phone: (305) 628-6117

The provider's authorized official is Mary Chen .
The authorized official title is Executive and has the following contact phone number (305) 628-6117.

The CLIA number assigned to this NPI record is 39D2187975 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/3/2019 and was last updated on 6/18/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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