DEDICATED PENNSYLVANIA HOLDING, LLC

PHILADELPHIA, PA
NPI1841707965
Other NameDEDICATED PENNSYLVANIA OLNEY
Entity TypeOrganization
Authorized ContactRAYMOND JIMENEZ
Director Of Client Services
305-628-6117
Organization Subpart ?Yes
Primary Taxonomy174400000X Specialist
Additional Taxonomies207Q00000X Family Medicine
207R00000X Internal Medicine
207RG0300X Internal Medicine, Geriatric Medicine
332900000X Non-Pharmacy Dispensing Site
Enumeration Date2018-01-10
Last Update Date2018-03-27
Business Address
DEDICATED PENNSYLVANIA HOLDING, LLC
5675 N FRONT ST STE 141
PHILADELPHIA, PA 19120-2719
Phone number: 305-628-6117
Mailing Address
DEDICATED PENNSYLVANIA HOLDING, LLC
1395 N.W/ 167TH STREET PAYER ENROLLMENT DEPARTMENT
MIAMI GARDENS, FL 33169
Phone number: 305-628-6117