Provider Demographics
NPI:1376871632
Name:PHILADELPHIA HEALTH & EDUCATION CORPORATION
Entity Type:Organization
Organization Name:PHILADELPHIA HEALTH & EDUCATION CORPORATION
Other - Org Name:DREXEL CONVENIENT CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXEC. DIRECTOR OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:LOU
Authorized Official - Middle Name:
Authorized Official - Last Name:MEINDL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-762-1321
Mailing Address - Street 1:1601 CHERRY ST
Mailing Address - Street 2:SUITE 11511
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-1321
Mailing Address - Country:US
Mailing Address - Phone:215-255-7822
Mailing Address - Fax:215-255-7825
Practice Address - Street 1:1625 CHESTNUT ST
Practice Address - Street 2:THE SHOPS AT LIBERTY PLACE - SPACE 172
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19103-4206
Practice Address - Country:US
Practice Address - Phone:215-255-7766
Practice Address - Fax:215-255-7825
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-25
Last Update Date:2014-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA021136Medicare PIN