Organization
DEDICATED PENNSYLVANIA HOLDING, LLC
Active
Parent organization
DEDICATED PENNSYLVANIA HOLDING, LLC
Other names
Dedicated Senior Medical Center South Philadelphia
Organization subpart
Yes
Provider details
NPI number
Legal business name
DEDICATED PENNSYLVANIA HOLDING, LLC
Authorized official
MARY CHEN (AUTHORIZED OFFICIAL)
(305) 831-4722
Entity
Organization
Contact information
Practice address
330 W OREGON AVE # 170, PHILADELPHIA, PA 19148-4723
(305) 628-6117
Mailing address
1395 NW 167TH ST, MIAMI GARDENS, FL 33169-5710
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
332900000X
Non-Pharmacy Dispensing Site
—
—
Other
Enumeration date
12/03/2019
Last updated
10/31/2024
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