Organization
SAINT AGNES CONTINUING CARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID SCHMOTZER SR. (DIRECTOR OF FINANCE)
(215) 339-4533
Entity
Organization
Contact information
Practice address
1900 S BROAD ST, PHILADELPHIA, PA 19145-2304
(215) 339-4223
(215) 339-0482
Mailing address
1900 S BROAD ST, PHILADELPHIA, PA 19145-2304
(215) 339-4223
(215) 339-0482
Taxonomy
Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003050510004
—
PA
Enumeration date
02/16/2007
Last updated
04/11/2019
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