Provider Demographics
NPI:1306514138
Name:PUBLIC HEALTH MANAGEMENT CORPORATION
Entity type:Organization
Organization Name:PUBLIC HEALTH MANAGEMENT CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIR-FINANCE AND REGULATORY AFFAIRS
Authorized Official - Prefix:
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 1:1500 MARKET ST.
Mailing Address - Street 2:CENTRE SQ EAST 17TH FLR ATTN: D. PRITCHARD
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102
Mailing Address - Country:US
Mailing Address - Phone:215-731-2406
Mailing Address - Fax:267-765-2325
Practice Address - Street 1:4601 MARKET ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19139-4636
Practice Address - Country:US
Practice Address - Phone:215-985-2500
Practice Address - Fax:267-765-2325
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-07
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)