Provider Demographics
NPI:1083866263
Name:PLANNED PARENTHOOD KEYSTONE
Entity type:Organization
Organization Name:PLANNED PARENTHOOD KEYSTONE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIR OF HEALTH SERVICES & SYSTEMS
Authorized Official - Prefix:
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMPTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-709-6074
Mailing Address - Street 1:PO BOX 1068
Mailing Address - Street 2:
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020-5068
Mailing Address - Country:US
Mailing Address - Phone:610-481-0481
Mailing Address - Fax:215-443-5405
Practice Address - Street 1:1514 N 2ND ST
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17102-2505
Practice Address - Country:US
Practice Address - Phone:717-234-2468
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PLANNED PARENTHOOD KEYSTONE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-10-21
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD056874L261Q00000X, 261QA0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1000073270026Medicaid