Provider Demographics
NPI:1881018018
Name:CITY OF PHILADELPHIA
Entity Type:Organization
Organization Name:CITY OF PHILADELPHIA
Other - Org Name:HEALTH CENTER 2
Other - Org Type:Doing Business As
Authorized Official - Title/Position:REGIONAL MANAGER/FINANCIAL SERVICES
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:STEVENSON
Authorized Official - Suffix:
Authorized Official - Credentials:BS, MBA
Authorized Official - Phone:215-685-6792
Mailing Address - Street 1:500 S BROAD ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19146-1613
Mailing Address - Country:US
Mailing Address - Phone:215-685-6843
Mailing Address - Fax:215-685-6700
Practice Address - Street 1:1930 S BROAD ST
Practice Address - Street 2:UNIT 14, 5TH FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19145-2328
Practice Address - Country:US
Practice Address - Phone:215-685-1803
Practice Address - Fax:215-685-6700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-07
Last Update Date:2014-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)