ABSOLUTECARE OF PHILADELPHIA LLC NPI 1437662772

NPI Information

NPI: 1437662772
Provider Name: ABSOLUTECARE OF PHILADELPHIA, LLC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 39D2151021

Address:
1080 N DELAWARE AVE STE 800
PHILADELPHIA, PA
ZIP 19125
Phone: (267) 463-5800
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ABSOLUTECARE OF PHILADELPHIA, LLC is a primary care clinic center in Philadelphia, PA. ABSOLUTECARE OF PHILADELPHIA, LLC NPI is 1437662772. The provider is registered as an organization entity type.

The provider's business location address is:

1080 N DELAWARE AVE STE 800
PHILADELPHIA, PA
ZIP 19125
Phone: (267) 463-5800
Fax: (215) 586-6038

The provider's authorized official is Thomas J Trently .
The authorized official title is Cfo and has the following contact phone number (443) 738-0281.

The CLIA number assigned to this NPI record is 39D2151021 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/8/2017 and was last updated on 2/3/2021.

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	291U00000X	Clinical Medical Laboratory				No
2	261QP2300X	Clinic/Center	Primary Care			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	1035008190001	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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