| NPI | 1023485265 |
|---|---|
| Doing Business As | GPHA SOUTH PHILADELPHIA HEALTH CTR. |
| Entity Type | Organization |
| Authorized Contact | D TINA SMITH Provider Enrollment Spec. 215-925-2400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2015-08-24 |
| Last Update Date | 2017-03-15 |