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Organization

ESPERANZA HEALTH CENTER INC

Active
Parent organization
ESPERANZA HEALTH CENTER
Organization subpart
Yes

Provider details

NPI number
Legal business name
ESPERANZA HEALTH CENTER
Authorized official
MRS. GLENNA J DEEM (CREDENTIALING MANAGER)
(215) 302-3600
Entity
Organization

Contact information

Practice address
4417 N. 6TH ST., PHILADELPHIA, PA 19140-2319
(215) 302-3600
(215) 329-2369
Mailing address
4417 N. 6TH ST., PHILADELPHIA, PA 19140-2319
(215) 302-3600
(215) 807-8395

Taxonomy

Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1007734560009
PA
01
153891
MEDICARE PART B PTAN
Enumeration date
08/03/2011
Last updated
03/29/2016
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