Provider Demographics
NPI:1619177961
Name:NORTH PHILADELPHIA HEALTH SYSTEM
Entity Type:Organization
Organization Name:NORTH PHILADELPHIA HEALTH SYSTEM
Other - Org Name:NPHS GMC D & A PARTIAL HOSPITALIZATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:J
Authorized Official - Last Name:WALMSLEY
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:215-787-9001
Mailing Address - Street 1:801 W GIRARD AVE
Mailing Address - Street 2:
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19122-4212
Mailing Address - Country:US
Mailing Address - Phone:215-787-2387
Mailing Address - Fax:215-787-2115
Practice Address - Street 1:801 W GIRARD AVE
Practice Address - Street 2:
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19122-4212
Practice Address - Country:US
Practice Address - Phone:215-787-2387
Practice Address - Fax:215-787-2115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-24
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA711301261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007276960106Medicaid