Provider Demographics
NPI:1164445128
Name:NORTH PHILADELPHIA HEALTH SYSTEM
Entity type:Organization
Organization Name:NORTH PHILADELPHIA HEALTH SYSTEM
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:GERRI
Authorized Official - Middle Name:H
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-787-9001
Mailing Address - Street 1:801 W GIRARD AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19122-4212
Mailing Address - Country:US
Mailing Address - Phone:215-787-2000
Mailing Address - Fax:215-787-2115
Practice Address - Street 1:801 W GIRARD AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19122-4212
Practice Address - Country:US
Practice Address - Phone:215-787-2000
Practice Address - Fax:215-787-2115
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTH PHILADELPHIA HEALTH SYSTEM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-25
Last Update Date:2020-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100727696Medicaid
PA117014OtherCOMMUNITY BEHAVIOR HEALTH