| Absolutecare Of Philadelphia, Llc | |
|
1080 N Delaware Ave Ste 800 Philadelphia PA 19125 | |
| (267) 463-5800 | |
| (215) 586-6038 |
| Full Name | Absolutecare Of Philadelphia, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1080 N Delaware Ave Ste 800, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Thomas J Trently (CFO) |
| Authorized Official Contact | 4437380281 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Absolutecare Of Philadelphia, Llc 1080 N Delaware Ave Ste 800 Philadelphia PA 19125-4330 Ph: (267) 463-5800 | Absolutecare Of Philadelphia, Llc 1080 N Delaware Ave Ste 800 Philadelphia PA 19125 Ph: (267) 463-5800 |
| NPI Number | 1437662772 |
|---|---|
| Provider Enumeration Date | 11/08/2017 |
| Last Update Date | 02/03/2021 |
| Medicare PECOS PAC ID | 3375560394 |
|---|---|
| Medicare Enrollment ID | O20180713001217 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437662772 | NPI | - | NPPES |
| 1035008190001 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| 291U00000X | Clinical Medical Laboratory | (* (Not Available)) | Secondary |
| Provider Name | Alishia Richie |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699773473 PECOS PAC ID: 6103857842 Enrollment ID: I20050823000537 |
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