PHILADELPHIA FIGHT NPI 1487082608

NPI Information

  • NPI: 1487082608
  • Provider Name: PHILADELPHIA FIGHT
  • Classification: Clinic/Center - 261QF0400X
  • Specialization: Federally Qualified Health Center (FQHC)
  • Entity Type: Organization
  • Address: 1233 LOCUST ST FL 4
    PHILADELPHIA, PA
    ZIP 19107
  • Phone: (215) 790-1788

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NPI Details

PHILADELPHIA FIGHT is a federally qualified health center (fqhc) clinic center in Philadelphia, PA. PHILADELPHIA FIGHT NPI is 1487082608. The provider is registered as an organization entity type.

The provider's business location address is:

1233 LOCUST ST FL 4
PHILADELPHIA, PA
ZIP 19107-459
Phone: (215) 790-1788
Fax: (215) 732-5490

The provider's authorized official is Jose J Virella .
The authorized official title is Cfo and has the following contact phone number (917) 842-3011.

The enumeration date for this NPI number is 10/25/2013 and was last updated on 11/3/2022.

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
1261QF0400XClinic/CenterFederally Qualified Health Center (FQHC)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
1100747222MEDICAIDPENNSYLVANIA

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: 11/21/2025

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