| NPI | 1164953998 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY S. FENNELL Ower 215-740-4213 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: PA MSG005039) |
| Enumeration Date | 2017-03-23 |
| Last Update Date | 2017-03-23 |