| Cap Clinic Cap Iop | |
|
801 W Girard Ave Phila PA 19122-4212 | |
| (215) 787-2387 | |
| Not Available |
| Full Name | Cap Clinic Cap Iop |
|---|---|
| Speciality | Clinic/center |
| Location | 801 W Girard Ave, Phila, Pennsylvania |
| Authorized Official Name and Position | Gerri H Walker (CEO) |
| Authorized Official Contact | 2157879001 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cap Clinic Cap Iop 801 W Girard Ave Attn Business Office Philadelphia PA 19122-4212 Ph: (215) 787-2387 | Cap Clinic Cap Iop 801 W Girard Ave Phila PA 19122-4212 Ph: (215) 787-2387 |
| NPI Number | 1023218302 |
|---|---|
| Provider Enumeration Date | 07/24/2007 |
| Last Update Date | 08/03/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023218302 | NPI | - | NPPES |
| 1007276960016 | Medicaid | PA | |
| 1007276960112 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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