Organization
PHILADELPHIA HEALTH MANAGEMENT CORP
Active
Organization
PHILADELPHIA HEALTH MANAGEMENT CORP
Active
Other names
Prise-OP
Organization subpart
No
Provider details
NPI number
Authorized official
SHANTE PENNINGTON (BILLING COORDINATOR)
(215) 731-2042
Entity
Organization
Contact information
Practice address
4329 GRISCOM ST, PHILA, PA 19124-5021
(215) 731-2042
(267) 765-2380
Mailing address
260 S BROAD ST, 18TH FLOOR, PHILA, PA 19102-5021
(215) 731-2042
(267) 765-2380
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000016640043
—
PA
Enumeration date
11/16/2007
Last updated
07/25/2008
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