Organization
GREATER PHILADELPHIA HEALTH ACTION INC.
Active
Other names
GPHA - Carl Moore Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
D TINA SMITH (PROVIDER ENROLLMENT SPEC.)
(215) 925-2400
Entity
Organization
Contact information
Practice address
1401 S. 31ST STREET, PHILADELPHIA, PA 19146-3506
(215) 925-2400
(215) 925-9162
Mailing address
1401 S. 31ST STREET, 2ND FLOOR, PHILADELPHIA, PA 19146-3506
(215) 925-2400
(215) 925-9162
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
08/15/2016
Last updated
03/15/2017
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