| Phila. Inc. | |
|
836 W 1st North St Morristown TN 37814-4548 | |
| (423) 616-0213 | |
| Not Available |
| Full Name | Phila. Inc. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 836 W 1st North St, Morristown, Tennessee |
| Authorized Official Name and Position | William Butler (DIRECTOR OF PROGRAMMING) |
| Authorized Official Contact | 8653066362 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Phila. Inc. 836 W 1st North St Morristown TN 37814-4548 Ph: (423) 616-0213 | Phila. Inc. 836 W 1st North St Morristown TN 37814-4548 Ph: (423) 616-0213 |
| NPI Number | 1982044095 |
|---|---|
| Provider Enumeration Date | 07/03/2013 |
| Last Update Date | 05/26/2021 |
| Certification Date | 05/26/2021 |
| Medicare PECOS PAC ID | 4385926534 |
|---|---|
| Medicare Enrollment ID | O20190506002089 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982044095 | NPI | - | NPPES |
| Provider Name | Daniel J Luke |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174636542 PECOS PAC ID: 8820056435 Enrollment ID: I20041229000683 |
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