Organization
WEDGE MEDICAL CENTER
Active
Organization
WEDGE MEDICAL CENTER
Active
Parent organization
WEDGE MEDICAL CENTER, PC
Other names
Wedge Medical Center, PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
WEDGE MEDICAL CENTER, PC
Authorized official
TAKISA GALLMAN (VP ADMINISTRATIVE SERVICES)
(215) 276-3922
Entity
Organization
Contact information
Practice address
3600 GERMANTOWN AVE, PHILADELPHIA, PA 19140-4226
(215) 223-3600
(215) 223-2100
Mailing address
6711 OLD YORK RD OFC, PHILADELPHIA, PA 19126-2841
(215) 276-3922
(215) 276-1249
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001680493
—
PA
Enumeration date
07/19/2019
Last updated
01/12/2021
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