Organization
DEDICATED PENNSYLVANIA HOLDING, LLC
Active
Parent organization
DEDICATED PENNSYLVANIA HOLDING, LLC
Other names
Dedicated Pennsylvania Olney
Organization subpart
Yes
Provider details
NPI number
Legal business name
DEDICATED PENNSYLVANIA HOLDING, LLC
Authorized official
RAYMOND JIMENEZ (DIRECTOR OF CLIENT SERVICES)
(305) 628-6117
Entity
Organization
Contact information
Practice address
5675 N FRONT ST STE 141, PHILADELPHIA, PA 19120-2719
(305) 628-6117
Mailing address
1395 N.W/ 167TH STREET, PAYER ENROLLMENT DEPARTMENT, MIAMI GARDENS, FL 33169
(305) 628-6117
(786) 870-4039
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
332900000X
Non-Pharmacy Dispensing Site
—
—
Other
Enumeration date
01/10/2018
Last updated
03/27/2018
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us