Provider Demographics
NPI:1598869059
Name:CHILDRENS HEALTH CARE ASSOCIATES, INC
Entity Type:Organization
Organization Name:CHILDRENS HEALTH CARE ASSOCIATES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHERISH
Authorized Official - Middle Name:
Authorized Official - Last Name:FLOWERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-425-9408
Mailing Address - Street 1:100 E PENN SQ FL 9
Mailing Address - Street 2:CHILDRENS HEALTH CARE ASSOCIATES
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-3377
Mailing Address - Country:US
Mailing Address - Phone:267-425-9408
Mailing Address - Fax:267-425-9299
Practice Address - Street 1:3401 CIVIC CENTER BLVD
Practice Address - Street 2:CHILDREN'S HOSPITAL OF PHILADELPHIA
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4319
Practice Address - Country:US
Practice Address - Phone:215-590-1000
Practice Address - Fax:267-425-9233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-12
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01156798Medicaid
PA0006558520003Medicaid
MS09016281Medicaid
NJ3316602Medicaid
DE0000188502Medicaid