| Rising Sun Family Practice Center, Inc. | |
|
7131 Rising Sun Ave Philadephia PA 19111-3924 | |
| (215) 742-9700 | |
| (215) 742-0828 |
| Full Name | Rising Sun Family Practice Center, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 7131 Rising Sun Ave, Philadephia, Pennsylvania |
| Authorized Official Name and Position | Andrew Scott Poulshock (PRESIDENT PHYSICIAN) |
| Authorized Official Contact | 2157429700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rising Sun Family Practice Center, Inc. 7131 Rising Sun Ave Philadephia PA 19111-3924 Ph: (215) 742-9700 | Rising Sun Family Practice Center, Inc. 7131 Rising Sun Ave Philadephia PA 19111-3924 Ph: (215) 742-9700 |
| NPI Number | 1750449468 |
|---|---|
| Provider Enumeration Date | 12/05/2006 |
| Last Update Date | 08/13/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750449468 | NPI | - | NPPES |
| 0010589360003 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |