Provider Demographics
NPI:1063656353
Name:PLANNED PARENTHOOD SOUTHEASTERN PENNSYLVANIA
Entity Type:Organization
Organization Name:PLANNED PARENTHOOD SOUTHEASTERN PENNSYLVANIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:VERA
Authorized Official - Middle Name:
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-351-5536
Mailing Address - Street 1:1144 LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-6734
Mailing Address - Country:US
Mailing Address - Phone:215-351-5100
Mailing Address - Fax:215-351-5595
Practice Address - Street 1:2751 COMLY RD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19154-2101
Practice Address - Country:US
Practice Address - Phone:267-687-6640
Practice Address - Fax:215-464-2246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-30
Last Update Date:2009-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA020659291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory