Organization
WMC
Active
Parent organization
THE WEDGE MEDICAL CENTER, P.C.
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE WEDGE MEDICAL CENTER, P.C.
Authorized official
TAKISA S GALLMAN (VP ADMINISTRATIVE SERVICES)
(215) 276-3922
Entity
Organization
Contact information
Practice address
4913 N BROAD ST, PHILADELPHIA, PA 19141-2215
(215) 276-3922
(215) 276-8199
Mailing address
6711 OLD YORK RD OFC, PHILADELPHIA, PA 19126-2841
(215) 276-3922
(215) 276-1249
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
07/18/2019
Last updated
07/18/2019
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