Organization
GREATER PHILADELPHIA HEALTH ACTION INC.
Active
Other names
GPHA Woodland Avenue Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. D. TINA SMITH (PROVIDER ENROLLMENT SPEC.)
(215) 925-2400
Entity
Organization
Contact information
Practice address
5000 WOODLAND AVE, PHILADELPHIA, PA 19143-5137
(215) 726-9807
(215) 726-0424
Mailing address
1401 S 31ST ST, 2ND FLOOR, PHILADELPHIA, PA 19146-3506
(215) 925-2400
(215) 925-9162
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
208000000X
Pediatrics Physician
—
—
2080C0008X
Child Abuse Pediatrics Physician
—
—
213E00000X
Podiatrist
—
—
261Q00000X
Clinic/Center
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1001374480052
—
PA
Enumeration date
05/23/2006
Last updated
03/16/2017
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