PENNCARE-J. EDWIN WOOD CLINIC NPI 1104967918

NPI Information

PENNCARE-J. EDWIN WOOD CLINIC 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.) PENNCARE-J. EDWIN WOOD CLINIC NPI is 1104967918. The provider is registered as an organization entity type.

The provider's business location address is:

700 SPRUCE ST
304
PHILADELPHIA, PA
ZIP 19106-022
Phone: (215) 829-3532

The provider's authorized official is Kenny Heine .
The authorized official title is Director Of Operations and has the following contact phone number (858) 625-2990.

The enumeration date for this NPI number is 2/12/2007 and was last updated on 12/4/2012.

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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