Organization
TRANSITION PHASE III
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JO BENOIT (CEO)
(215) 878-2052
Entity
Organization
Contact information
Practice address
3900 CITY AVE, MADISON BUILDING, SUITE 1207, PHILADELPHIA, PA 19131-2908
(215) 878-3052
Mailing address
3900 CITY AVE, MADISON BUILDING, SUITE 1207, PHILADELPHIA, PA 19131-2908
(215) 878-3052
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
—
Other
Enumeration date
11/14/2008
Last updated
11/14/2008
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