Provider Demographics
NPI:1194136705
Name:FEDERAL BUREAU OF PRISONS
Entity type:Organization
Organization Name:FEDERAL BUREAU OF PRISONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT HSA
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-521-4091
Mailing Address - Street 1:700 ARCH ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19106-1548
Mailing Address - Country:US
Mailing Address - Phone:215-521-4091
Mailing Address - Fax:215-521-4083
Practice Address - Street 1:700 ARCH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19106-1548
Practice Address - Country:US
Practice Address - Phone:215-521-4091
Practice Address - Fax:215-521-4083
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-16
Last Update Date:2014-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2400XAmbulatory Health Care FacilitiesClinic/CenterPrison Health