Organization
COGENT HEALTHCARE OF PENNSYLVANIA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN A. BROWNIE (TREASURER)
(615) 377-5630
Entity
Organization
Contact information
Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(615) 377-5670
(615) 377-1678
Mailing address
5410 MARYLAND WAY, SUITE 300, BRENTWOOD, TN 37027-5064
(615) 377-5670
(615) 377-1687
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
363LA2100X
Acute Care Nurse Practitioner
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0870632000
BCBS PA
PA
05
—
1017423290001
—
PA
05
—
1017423290002
—
PA
01
—
2090161
HIGHMARK BLUE SHIELD
PA
Enumeration date
06/26/2006
Last updated
11/05/2009
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