Provider Demographics
NPI:1831258045
Name:CITY OF PHILADELPHIA
Entity type:Organization
Organization Name:CITY OF PHILADELPHIA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ASSOCIATE ADMINISTRATOR, FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:SCANNAPIECO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-685-0800
Mailing Address - Street 1:2100 W GIRARD AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19130-1400
Mailing Address - Country:US
Mailing Address - Phone:215-685-0800
Mailing Address - Fax:215-685-0975
Practice Address - Street 1:2100 W GIRARD AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19130-1400
Practice Address - Country:US
Practice Address - Phone:215-685-0800
Practice Address - Fax:215-685-0975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2009-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA163902314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0007561580001Medicaid
PA1000076950094Medicaid
PA1000076950094Medicaid