Organization
GREATER PHILADELPHIA HEALTH ACTION, INC.
Active
Other names
GPHA Inc Nutritionist Group
Organization subpart
No
Provider details
NPI number
Authorized official
MS. D TINA SMITH (PROVIDER ENROLLMENT SPEC.)
(215) 925-2400
Entity
Organization
Contact information
Practice address
4510 FRANKFORD AVE, PHILADELPHIA, PA 19124-3602
(215) 744-1302
(215) 744-2544
Mailing address
1401 S 31ST ST, 2ND FLOOR, PHILADELPHIA, PA 19146-3506
(215) 925-2400
(215) 925-9162
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
—
—
261Q00000X
Clinic/Center
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
03/04/2010
Last updated
04/03/2017
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