Provider Demographics
NPI:1821444209
Name:FOX SUBACUTE AT SOUTH PHILADELPHIA LLC
Entity Type:Organization
Organization Name:FOX SUBACUTE AT SOUTH PHILADELPHIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT AND GENERAL COUNSEL
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:F
Authorized Official - Last Name:MURRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-342-4153
Mailing Address - Street 1:251 STENTON AVE
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH MEETING
Mailing Address - State:PA
Mailing Address - Zip Code:19462-1246
Mailing Address - Country:US
Mailing Address - Phone:484-342-4153
Mailing Address - Fax:610-862-0614
Practice Address - Street 1:1930 SOUTH BROAD STREET
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19145
Practice Address - Country:US
Practice Address - Phone:484-342-4153
Practice Address - Fax:610-862-0614
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-04
Last Update Date:2016-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility