Organization
CITY OF PHILADELPHIA
Active
Other names
Health Care Center 2
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINE GADDY (BILLING MANAGER)
(215) 685-6843
Entity
Organization
Contact information
Practice address
1700 S BROAD ST APT 201, PHILADELPHIA, PA 19145-2340
(215) 685-1803
(215) 685-1815
Mailing address
500 S BROAD ST FL 2, INFORMATION & REIMBURSEMENT, PHILADELPHIA, PA 19146-1613
(215) 685-6863
(215) 685-6848
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000076950098
—
PA
05
—
1002859
—
PA
05
—
16792
—
PA
05
—
G0002730
—
PA
Enumeration date
08/24/2006
Last updated
11/25/2019
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