PHILADELPHIA VAMC (NPI# 1316324486) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316324486 |
| Entity Type | Organization |
| Organization Name | PHILADELPHIA VAMC |
| Other Organization Name | FOURTH STREET VA CLINIC |
| Practice Address |
213 N 4th St Philadelphia PA 19106-1801 |
| Mailing Address |
Po Box 3007 Lebanon PA 17042-3007 |
| Practice Telephone | 7172776565 |
| Mailing Telephone | 7172776565 |
| Enumeration Date | 2015-04-28 |
| Last Update Date | 2015-04-28 |
| Authorized Official Name | ERIN POTTER (NPI TEAM MEMBER) |
| Authorized Official Telephone | 2023822579 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QV0200X |
Clinic/Center Specialization: VA |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| FOURTH STREET VA CLINIC | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134517360 | Philadelphia Vamc | Clinic/Center | 4219 Chestnut St, Philadelphia, PA 19104-3014 | 2014-12-22 |
| 1750324406 | Philadelphia Vamc | Clinic/Center | 3000 Lincoln Drive, Suite E, Marlton, NJ 08053-1500 | 2006-06-13 |
| 1679933048 | Philadelphia Vamc | Psychiatric Residential Treatment Facility | 1425 Snyder Ave, Philadelphia, PA 19145-2317 | 2016-02-29 |
| 1841608882 | Philadelphia Vamc | Clinic/Center | 300 S Broadway, Suite 103, Camden, NJ 08103-1210 | 2014-07-22 |
| 1689618795 | Philadelphia Vamc | Clinic/Center | 433 Caredean Dr, Horsham, PA 19044-1321 | 2006-06-16 |
| 1669426086 | Philadelphia Vamc | Clinic/Center | 211 County House Rd, Sewell, NJ 08080-2525 | 2006-05-20 |
| 1659321693 | Philadelphia Vamc | Skilled Nursing Facility | 3900 Woodland Ave, Philadelphia, PA 19104-4551 | 2006-05-11 |
| 1124077144 | Philadelphia Vamc | Department of Veterans Affairs (VA) Pharmacy | 3900 Woodland Ave, Philadelphia, PA 19104-4551 | 2006-05-08 |
| Street Address |
213 N 4TH ST |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19106-1801 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518062025 | James Robert Grassi | Social Worker | 213 N 4th St, 2nd Floor, Philadelphia, PA 19106-1801 | 2006-09-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841807245 | Jaclyn Isis Lisberger | Speech-Language Pathologist | 130 North 2nd Street-#2e, Philadelphia, PA 19106 | 2020-09-29 |
| 1356964159 | Michelle Copija | Nurse Anesthetist, Certified Registered | Society Hill Anesthesia Consultants, P.C., 301 S. 8th St Suite 2l, Philadelphia, PA 19106 | 2020-05-27 |
| 1811468929 | Old City Orthodontics LLC | Clinic/Center | 14 S 3rd Street, 1st Floor, Philadelphia, PA 19106 | 2018-12-16 |
| 1437627569 | Peter James Voystock | Social Worker | Veterans' Multi-service Center, 2nd Floor, 213-217 N 4th St, Philadelphia, PA 19106 | 2018-11-07 |
| 1467975334 | Aasiyah's Inc | Nurse's Aide | 325-41 Chestnut Street Suite 800, Suite 800, Philadelphia, PA 19106 | 2017-07-21 |
| 1457883043 | Jackie Kurland | Registered Nurse | 301 S 8th St Ste 2l, Philadelphia, PA 19106 | 2017-04-01 |
| 1669851655 | Amy Hardenbergh | Nurse Anesthetist, Certified Registered | 325 Chestnut Street, Suite 210, Society Hill Anesthesia Consultants, Philadelphia, PA 19106 | 2015-05-22 |
| 1790178820 | Bita Khoshrou | Dentist | 604 S Washington Square, Philadelphia, PA 19106 | 2015-03-13 |
| 1144667262 | Krystal Maloni | Surgery | 700 Spruce St Ste 101, Philadelphia, PA 19106 | 2013-05-30 |
| 1487099305 | Aimee E Wood | Social Worker | 233 South 6th St, Suite C33, Philadelphia, PA 19106 | 2013-05-06 |
| Find all providers in zip 19106 | ||||
| Taxonomy Code | 261QV0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | VA |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407316219 | Philadelphia Va Medical Center | Clinic/Center | 6232 Market St Ste 100, Philadelphia, PA 19139-2922 | 2019-03-20 |
| 1134517360 | Philadelphia Vamc | Clinic/Center | 4219 Chestnut St, Philadelphia, PA 19104-3014 | 2014-12-22 |
| 1659315380 | Philadelphia Va Clinic | Clinic/Center | 214 North 4th St., 2nd Floor, Philadelphia, PA 19106 | 2006-06-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184012684 | Lebanon Vamc | Clinic/Center | 1 Garrison Rd, Building 4-114 Fort Indiantown Gap, Annville, PA 17003-5061 | 2015-01-06 |
| 1659779254 | Buffalo Vamc | Clinic/Center | 24 Maple View Ln, Suite 2, Coudersport, PA 16915-9527 | 2014-12-12 |
| 1851644967 | Altoona Vamc | Clinic/Center | 13903 William Penn Hwy, Mapleton Depot, PA 17052-9649 | 2012-10-26 |
| 1841340015 | Warren Cboc | Clinic/Center | 3 Farm Colony Dr, Warren, PA 16365-5209 | 2007-01-11 |
| 1184771123 | Pittsburgh Vamc | Clinic/Center | 635 Pittsburgh Rd, Suite 520, Uniontown, PA 15401-2215 | 2007-01-04 |
| 1740224971 | Wilkes Barre Vamc | Clinic/Center | Tobyhanna Army Depot, Bldg 220, Tobyhanna, PA 18466-5002 | 2006-06-16 |
| 1376585588 | Butler Vamc | Clinic/Center | 11 Hilltop Plz, Kittanning, PA 16201-8905 | 2006-06-12 |
| 1134168032 | Altoona Vamc | Clinic/Center | 2581 Clyde Avenue, State College, PA 16801-9998 | 2006-06-06 |
| 1598703118 | Erie Vamc | Clinic/Center | 23 Kennedy St, Bradford, PA 16701-2065 | 2006-06-04 |
| 1669410635 | Coatesville Vamc | Clinic/Center | 11 Independence Dr, Spring City, PA 19475-1239 | 2006-06-03 |
| Find all providers with the same taxonomy | ||||
| City | PHILADELPHIA |
| Zip Code | 19106 |
Please comment or provide details below to improve the information on PHILADELPHIA VAMC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.