Provider Demographics
NPI:1952495707
Name:QUALITY COMMUNITY HEALTH CARE, INC.
Entity Type:Organization
Organization Name:QUALITY COMMUNITY HEALTH CARE, INC.
Other - Org Name:COOKE FAMILY HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARCELLA
Authorized Official - Middle Name:E
Authorized Official - Last Name:LINGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:215-227-0300
Mailing Address - Street 1:2501 W. LEHIGH AVENUE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19132-3207
Mailing Address - Country:US
Mailing Address - Phone:215-227-0300
Mailing Address - Fax:215-227-0302
Practice Address - Street 1:1300 W. LOUDEN STREET
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19141-2603
Practice Address - Country:US
Practice Address - Phone:215-457-6902
Practice Address - Fax:215-457-6903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2019-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007588070012Medicaid
PA391970Medicare Oscar/Certification