| NPI | 1417105347 |
|---|---|
| Doing Business As | SPSI - BROAD STREET FAMILY HEALTH CENTER |
| Entity Type | Organization |
| Authorized Contact | KENNY HEINE VP Of Operations 858-625-2990 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: PA OS010593L) |
| Enumeration Date | 2008-09-04 |
| Last Update Date | 2015-12-17 |