| Fairmount Primary Care Center At St. Joseph's Hospital | |
|
1600 W Girard Ave Suite 201 Philadelphia PA 19130-1615 | |
| (215) 827-8010 | |
| (215) 765-2191 |
| Full Name | Fairmount Primary Care Center At St. Joseph's Hospital |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 1600 W Girard Ave, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Patricia Deitch (PRESIDENT & CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 2152359600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fairmount Primary Care Center At St. Joseph's Hospital 1412 Fairmount Ave Philadelphia PA 19130-2908 Ph: (215) 599-4851 | Fairmount Primary Care Center At St. Joseph's Hospital 1600 W Girard Ave Suite 201 Philadelphia PA 19130-1615 Ph: (215) 827-8010 |
| NPI Number | 1073819967 |
|---|---|
| Provider Enumeration Date | 02/10/2011 |
| Last Update Date | 06/07/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073819967 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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