Organization
PENROSE MEDICAL CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL P COACHI M.D (PRESIDENT)
(215) 276-8788
Entity
Organization
Contact information
Practice address
1603 E WADSWORTH AVE, PHILADELPHIA, PA 19150-1019
(215) 242-2439
(215) 242-2596
Mailing address
1603 E WADSWORTH AVE, PHILADELPHIA, PA 19150-1019
(215) 242-2439
(215) 242-2596
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
MD066378L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0017863200005
—
PA
Enumeration date
01/03/2008
Last updated
11/19/2015
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