Provider Demographics
NPI:1578861605
Name:PHILADELPHIA DEPT. OF PUBLIC HEALTH
Entity Type:Organization
Organization Name:PHILADELPHIA DEPT. OF PUBLIC HEALTH
Other - Org Name:DIVISION OF DISEASE CONTROL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR, DIV. OF DISEASE CONTROL
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROLINE
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-685-6741
Mailing Address - Street 1:500 S BROAD ST
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19146-1613
Mailing Address - Country:US
Mailing Address - Phone:215-685-6741
Mailing Address - Fax:215-545-8362
Practice Address - Street 1:500 S BROAD ST
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19146-1613
Practice Address - Country:US
Practice Address - Phone:215-685-6741
Practice Address - Fax:215-545-8362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-15
Last Update Date:2014-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local