Provider Demographics
NPI:1467613885
Name:SAFE MEADOW MEDICAL CENTER
Entity Type:Organization
Organization Name:SAFE MEADOW MEDICAL CENTER
Other - Org Name:SAFE MEADOW HEALTH CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:BIYI
Authorized Official - Middle Name:KAYODE
Authorized Official - Last Name:OYEFULE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-937-0700
Mailing Address - Street 1:7042 ELMWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19142-1722
Mailing Address - Country:US
Mailing Address - Phone:215-937-0700
Mailing Address - Fax:512-937-0164
Practice Address - Street 1:7042 ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19142-1722
Practice Address - Country:US
Practice Address - Phone:215-937-0700
Practice Address - Fax:512-937-0164
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-18
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD034392E251S00000X, 261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1011964430001Medicaid