Provider Demographics
NPI:1124240155
Name:STRAWBERRY MANSION HEALTH CENTER
Entity type:Organization
Organization Name:STRAWBERRY MANSION HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CHETWYND
Authorized Official - Middle Name:
Authorized Official - Last Name:BOWLING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-685-2422
Mailing Address - Street 1:2840 W DAUPHIN ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19132-4627
Mailing Address - Country:US
Mailing Address - Phone:215-685-2419
Mailing Address - Fax:
Practice Address - Street 1:1117 E SANGER ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19124-1130
Practice Address - Country:US
Practice Address - Phone:215-685-2419
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center