Provider Demographics
NPI:1437772795
Name:PUBLIC HEALTH MANAGMENT CORPORATION (PHMC)
Entity Type:Organization
Organization Name:PUBLIC HEALTH MANAGMENT CORPORATION (PHMC)
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIR OF FINANCE & REGULATORY AFFAIRS
Authorized Official - Prefix:
Authorized Official - First Name:JAY
Authorized Official - Middle Name:MILTON
Authorized Official - Last Name:WUSSOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-985-2575
Mailing Address - Street 1:1500 MARKET ST LOWR MEZZ
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-2100
Mailing Address - Country:US
Mailing Address - Phone:215-985-2500
Mailing Address - Fax:215-985-2550
Practice Address - Street 1:3300 HENRY AVE FL 2
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19129-1141
Practice Address - Country:US
Practice Address - Phone:215-643-5400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-21
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health