Provider Demographics
NPI:1457049439
Name:FAIR HILL COMMUNITY PHYSICIANS
Entity Type:Organization
Organization Name:FAIR HILL COMMUNITY PHYSICIANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR. MANAGER PAYER CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:BRIDGET
Authorized Official - Middle Name:
Authorized Official - Last Name:FERRARIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-707-2433
Mailing Address - Street 1:3500 N BROAD ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19140-4106
Mailing Address - Country:US
Mailing Address - Phone:215-324-0600
Mailing Address - Fax:215-324-2795
Practice Address - Street 1:133 W HUNTING PARK AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19140-2717
Practice Address - Country:US
Practice Address - Phone:215-324-0600
Practice Address - Fax:215-324-2795
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-27
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty