# JEFFERSON HEADACHE CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396079695
- **Authorized official:** MS. PATRICE S GUILD DIRECTOR, OPERATIONS (DIRECTOR OF OPERATIONS)
- **Authorized official phone:** (215) 955-2212

## Contact information

- **Practice address:** 111 S 11TH ST, SUITE 8130 GIBBON BUILDING, PHILADELPHIA, PA 19107-4824
- **Practice address phone:** (215) 955-2727
- **Practice address fax:** (215) 955-6682
- **Mailing address:** 111 S 11TH ST, SUITE 8130 GIBBON BUILDING, PHILADELPHIA, PA 19107-4824
- **Mailing address phone:** (215) 955-2727
- **Mailing address fax:** (215) 955-6682

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 282N00000X | General Acute Care Hospital | 438132 | PA | Yes |

## Other

- **Enumeration date:** 09/21/2009
- **Last updated:** 09/21/2009