SPECTRUM HEALTH SERVICES INC NPI 1881629012

NPI Information

NPI: 1881629012
Provider Name: SPECTRUM HEALTH SERVICES INC
Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

CLIA Number: 39D0907139

Address:
1415 NORTH BROAD STREET
BROAD STREET HEALTH CENTER
PHILADELPHIA, PA
ZIP 19122
Phone: (215) 235-7944
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SPECTRUM HEALTH SERVICES INC is a federally qualified health center (fqhc) clinic center in Philadelphia, PA. SPECTRUM HEALTH SERVICES INC NPI is 1881629012. The provider is registered as an organization entity type.

The provider's business location address is:

1415 NORTH BROAD STREET
BROAD STREET HEALTH CENTER
PHILADELPHIA, PA
ZIP 19122
Phone: (215) 235-7944
Fax: (215) 235-0813

The provider's authorized official is Phyllis B Cater .
The authorized official title is President & Ceo and has the following contact phone number (215) 471-2761.

The CLIA number assigned to this NPI record is 39D0907139 - federally qualified health center with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 7/12/2006 and was last updated on 8/18/2015.

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	261QF0400X	Clinic/Center	Federally 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
1	091173	OTHER		HIGHMARK BLUE SHIELD
2	1007288260005	MEDICAID	PENNSYLVANIA
3	391883	MEDICARE OSCAR/CERTIFICATION	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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