Organization
ESPERANZA HEALTH CENTER INC
Active
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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