Provider Demographics
NPI:1598817603
Name:TEMPLE PHYSICIANS INC.
Entity Type:Organization
Organization Name:TEMPLE PHYSICIANS INC.
Other - Org Name:PORT RICHMOND FAMILY MEDICINE
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LYNNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SAVERING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-926-9015
Mailing Address - Street 1:PO BOX 820933
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19182-0933
Mailing Address - Country:US
Mailing Address - Phone:215-926-9010
Mailing Address - Fax:215-226-8285
Practice Address - Street 1:2923-25 E THOMPSON STREET
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19134-4812
Practice Address - Country:US
Practice Address - Phone:215-425-3981
Practice Address - Fax:215-425-8083
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TEMPLE PHYSICIANS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-17
Last Update Date:2016-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007278000070Medicaid
PA597586Medicare PIN
PA1007278000070Medicaid