Provider Demographics
NPI:1144502634
Name:PUBLIC HEALTH MANAGEMENT CORP
Entity type:Organization
Organization Name:PUBLIC HEALTH MANAGEMENT CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR - OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:KILLIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-985-2514
Mailing Address - Street 1:260 S BROAD ST FL 18
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-5000
Mailing Address - Country:US
Mailing Address - Phone:215-985-2514
Mailing Address - Fax:267-765-2325
Practice Address - Street 1:216 W SOMERSET ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19133-3534
Practice Address - Country:US
Practice Address - Phone:215-763-8870
Practice Address - Fax:215-291-9153
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-12
Last Update Date:2012-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)