Organization
PLANNED PARENTHOOD SOUTHEASTERN PENNSYLVANIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VERA BAILEY (CFO)
(215) 351-5536
Entity
Organization
Contact information
Practice address
1144 LOCUST ST, PHILADELPHIA, PA 19107-6734
(215) 351-5500
(215) 351-5595
Mailing address
1144 LOCUST ST, PHILADELPHIA, PA 19107-6734
(215) 351-5500
(215) 351-5595
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
—
—
208800000X
Urology Physician
—
—
261Q00000X
Clinic/Center
Primary
—
—
261QA0005X
Ambulatory Family Planning Facility
—
—
261QA1903X
Ambulatory Surgical Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
332900000X
Non-Pharmacy Dispensing Site
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0060242000
IBC PROVIDER #
PA
05
—
1007730530001
—
PA
01
—
156525
BCBLUE S PROVIDER #
PA
01
—
5066359
AETNA PROVIDER #
PA
Enumeration date
01/16/2007
Last updated
09/09/2009
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