Provider Demographics
NPI:1790950426
Name:COMMUNITY HEALTH COLLABORATIVE
Entity Type:Organization
Organization Name:COMMUNITY HEALTH COLLABORATIVE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:K
Authorized Official - Last Name:SCHNEIDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:267-972-0534
Mailing Address - Street 1:2130 N PALETHORP ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19122-1613
Mailing Address - Country:US
Mailing Address - Phone:267-972-0534
Mailing Address - Fax:215-425-4042
Practice Address - Street 1:2130 N PALETHORP ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19122-1613
Practice Address - Country:US
Practice Address - Phone:267-972-0534
Practice Address - Fax:215-425-4042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-24
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
No251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
105737Medicare PIN
C30226Medicare UPIN