Organization
MEN MAKERS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BERNARD SHEMAIAH COLLINS MSW (EXECUTIVE DIRECTOR)
(267) 242-0939
Entity
Organization
Contact information
Practice address
301 COBBS CREEK PKWY, PHILADELPHIA, PA 19143-1016
(267) 242-0939
(215) 474-5098
Mailing address
301 COBBS CREEK PKWY, PHILADELPHIA, PA 19143-1016
(267) 242-0939
(215) 474-5098
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
BH001116
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
51
—
PA
Enumeration date
12/12/2016
Last updated
12/12/2016
About Stedi
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