Organization
PLANNED PARENTHOOD SOUTHEASTERN PENNSYLVANIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VERA BAILEY (CFO)
(215) 351-5536
Entity
Organization
Contact information
Practice address
1211 CHESTNUT ST, SUITE 405, PHILADELPHIA, PA 19107-4103
(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
—
—
261QA0005X
Ambulatory Family Planning Facility
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
3336C0002X
Clinic Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0060242000
IBC PROVIDER #
PA
05
—
1007730530018
—
PA
01
—
156525
BC-BS PROVIDER #
PA
01
—
5066359
AETNA PROVIDER#
PA
Enumeration date
02/14/2007
Last updated
08/13/2014
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