Provider Demographics
NPI:1477592400
Name:AIDS CARE GROUP
Entity Type:Organization
Organization Name:AIDS CARE GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HOWELL
Authorized Official - Middle Name:
Authorized Official - Last Name:STRAUSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-872-9101
Mailing Address - Street 1:2304 EDGMONT AVE
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19013-5038
Mailing Address - Country:US
Mailing Address - Phone:610-872-9101
Mailing Address - Fax:610-872-9103
Practice Address - Street 1:2304 EDGMONT AVE
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19013-5038
Practice Address - Country:US
Practice Address - Phone:610-872-9101
Practice Address - Fax:610-872-9103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-05
Last Update Date:2019-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA057025Medicare ID - Type Unspecified