PENROSE MEDICAL CENTER INC NPI 1417132929

NPI Information

NPI: 1417132929
Provider Name: PENROSE MEDICAL CENTER, INC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
1603 E WADSWORTH AVE
PHILADELPHIA, PA
ZIP 19150
Phone: (215) 242-2439
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PENROSE MEDICAL CENTER, INC is a primary care clinic center in Philadelphia, PA. PENROSE MEDICAL CENTER, INC NPI is 1417132929. The provider is registered as an organization entity type.

The provider's business location address is:

1603 E WADSWORTH AVE
PHILADELPHIA, PA
ZIP 19150-019
Phone: (215) 242-2439
Fax: (215) 242-2596

The provider's authorized official is Daniel P Coachi .
The authorized official title is President and has the following contact phone number (215) 276-8788.

The enumeration date for this NPI number is 1/3/2008 and was last updated on 11/19/2015.

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:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care	MD066378L	PENNSYLVANIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0017863200005	MEDICAID	PENNSYLVANIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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