PENNCARE-J. EDWIN WOOD CLINIC

PHILADELPHIA, PA
NPI1104967918
Entity TypeOrganization
Authorized ContactKENNY HEINE
Director Of Operations
858-625-2990
Organization Subpart ?Yes
Primary Taxonomy332900000X Non-Pharmacy Dispensing Site
(Licence: PA  OS012672)
Enumeration Date2007-02-12
Last Update Date2012-12-04
Business Address
PENNCARE-J. EDWIN WOOD CLINIC
700 SPRUCE ST 304
PHILADELPHIA, PA 19106-4022
Phone number: 215-829-3532
Mailing Address
PENNCARE-J. EDWIN WOOD CLINIC
5626 OBERLIN DR SUITE 110
SAN DIEGO, CA 92121-1705
Phone number: