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Organization

PENN PRESBYTERIAN MEDICAL CTR DETOX REHAB

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. THOMAS MCCORMICK (ASSISTANT VICE PRESIDENT FINANCE)
(215) 762-0888
Entity
Organization

Contact information

Practice address
51 N 39TH ST, PHILA, PA 19104-2640
(215) 796-4640
(609) 770-7792
Mailing address
1500 MARKET ST, UM600, PHILA, PA 19102-2100
(215) 796-4640
(609) 770-7792

Taxonomy

Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1007297070001
PA
Enumeration date
02/06/2007
Last updated
03/30/2023
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