| Gpha Inc. Medical Suite At Temple's Dental School | |
|
3223 N Broad St Philadelphia PA 19140-5007 | |
| (215) 226-3789 | |
| (215) 226-3794 |
| Full Name | Gpha Inc. Medical Suite At Temple's Dental School |
|---|---|
| Speciality | Clinic/Center |
| Location | 3223 N Broad St, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | D Tina Smith (PROVIDER ENROLLMENT SPEC.) |
| Authorized Official Contact | 2159252400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gpha Inc. Medical Suite At Temple's Dental School 1401 S 31st St 2nd Floor Philadelphia PA 19146-3506 Ph: (215) 925-2400 | Gpha Inc. Medical Suite At Temple's Dental School 3223 N Broad St Philadelphia PA 19140-5007 Ph: (215) 226-3789 |
| NPI Number | 1326493321 |
|---|---|
| Provider Enumeration Date | 04/27/2016 |
| Last Update Date | 03/15/2017 |
| Medicare PECOS PAC ID | 9537064977 |
|---|---|
| Medicare Enrollment ID | O20160516001089 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326493321 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Secondary |
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