| Mercy Management Of Southeastern Pennsylvania | |
|
6323 Vine St Philadelphia PA 19139-1032 | |
| (215) 748-8303 | |
| (215) 748-8660 |
| Full Name | Mercy Management Of Southeastern Pennsylvania |
|---|---|
| Speciality | Internal Medicine |
| Location | 6323 Vine St, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Don Halberstadt (CFO) |
| Authorized Official Contact | 6105676964 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mercy Management Of Southeastern Pennsylvania 1 W Elm St Conshohocken PA 19428-2007 Ph: (610) 567-6964 | Mercy Management Of Southeastern Pennsylvania 6323 Vine St Philadelphia PA 19139-1032 Ph: (215) 748-8303 |
| NPI Number | 1932198157 |
|---|---|
| Provider Enumeration Date | 10/20/2005 |
| Last Update Date | 07/19/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932198157 | NPI | - | NPPES |
| 2247379004 | Other | PA | KEYSTONE HEALTH PLAN EAST |
| 36431 | Other | PA | HEALTH PARTNERS |
| DA5351 | Other | PA | RAILROAD MEDICARE |
| 30010755 | Other | PA | KEYSTONE MERCY HEALTH PLA |
| 1007787930163 | Medicaid | PA | |
| 1555770 | Other | PA | BLUE SHIELD |
| 61258870002 | Other | PA | CIGNA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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