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Organization

SPECTRUM HEALTH SERVICES INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JESSICA MOORE (CREDENTIALING MANAGER)
(215) 730-7356
Entity
Organization

Contact information

Practice address
2300 W MASTER ST, PHILADELPHIA, PA 19121-4996
(215) 471-2761
(215) 689-4236
Mailing address
5201 HAVERFORD AVE, SPECTRUM HEALTH SERVICES, INC, PHILADELPHIA, PA 19139-1401
(215) 471-2761
(215) 472-6093

Taxonomy

Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
091173
HIGHMARK BLUE SHIELD
05
1007288260005
PA
Enumeration date
07/12/2006
Last updated
05/12/2026
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