BRANCH MEDICAL CLINIC PHILADELPHIA (NPI# 1609381623) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609381623 |
| Entity Type | Organization |
| Organization Name | BRANCH MEDICAL CLINIC PHILADELPHIA |
| Practice Address |
4898 S Broad St Philadelphia PA 19112-1320 |
| Mailing Address |
250 Wood Rd Annapolis MD 21402-1257 |
| Practice Telephone | 2158978147 |
| Enumeration Date | 2017-12-13 |
| Last Update Date | 2017-12-13 |
| Authorized Official Name | WILLIAM M CONDON (BUMED UBO) |
| Authorized Official Telephone | 2404013643 |
| Is Organization Subpart | Y |
| Parent Organization Name | NAVAL HEALTH CLINIC ANNAPOLIS |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1100X |
Clinic/Center Specialization: Military/U.S. Coast Guard Outpatient |
Ambulatory Health Care Facilities |
| Street Address |
4898 S BROAD ST |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19112-1320 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265950802 | M&m Surgical Center PC | Clinic/Center | 1 Crescent Dr. Suite 300, Philadelphia, PA 19112 | 2017-09-05 |
| 1710114293 | Riverview Surgery Center At The Navy Yard Lp | Clinic/Center | Three Crescent Drive, Navy Yard Corporate Center, Philadelphia, PA 19112 | 2009-06-11 |
| 1023136942 | Susan Elizabeth Fredericks | Physician Assistant | 1 Crescent Drive Suite 100, Navy Yard Corporate Center, Philadelphia, PA 19112 | 2007-03-27 |
| 1023132867 | Healthmark, Incorporated | Clinic/Center | 1 Crescent Dr., Navy Yard Suite 100, Philadelphia, PA 19112 | 2007-03-19 |
| 1932526258 | Anne Catherine Kane | Otolaryngology | 3 Crescent Dr, Philadelphia, PA 19112 | 2014-03-25 |
| 1255539896 | Sheldon Gottlieb | Physical Medicine & Rehabilitation | 1 Crescent Dr, Suite 100, Philadelphia, PA 19112 | 2007-07-05 |
| 1407074750 | Jennifer L Johansen | Pharmacist | 5 Crescent Dr, Ny0200, Philadelphia, PA 19112-1001 | 2007-04-23 |
| 1679981708 | Andrew Trofa | Internal Medicine | 5 Crescent Dr, Ny 0300, Philadelphia, PA 19112-1001 | 2014-08-01 |
| 1508029463 | Robert Williams Carr | Preventive Medicine | 5 Crescent Dr, Ny 0300, Philadelphia, PA 19112-1001 | 2008-07-09 |
| 1952947152 | Navy Yard Dental Associates, Pllc | Dentist | 1 Crescent Dr Ste 300, Philadelphia, PA 19112-1015 | 2019-11-22 |
| Find all providers in zip 19112 | ||||
| Taxonomy Code | 261QM1100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Military/U.S. Coast Guard Outpatient |
| The Defense Health Program or U.S. Coast Guard funded "fixed" facilities or distinct parts of a facility, providing outpatient medical and dental services, primarily for Uniformed Services beneficiaries. A "fixed" facility is a non-temporary, non-deployed facility. It includes mobile specialty units such as Magnetic Resonance Imaging (MRI) units that may furnish services at the "fixed" facility. It includes, as examples, the institutional portion of outpatient encounters (except Ambulatory Procedure Visits), supplies issued (e.g., glasses, ostomy supplies, crutches), and radiology and laboratory studies. Does not include items issued directly to a patient from an outpatient pharmacy or patient transport. |
| Notes: Source: TRICARE Management Activity Uniform Business Office User’s Guide [1/1/2005: title modified, definition added; 7/1/2006 title modified, definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871709576 | Kimbrough Acc Military Mtf | Clinic/Center | 99 G Street, Bldg 400, New Cumberland, PA 17070 | 2007-05-16 |
| 1417163114 | Kimbrough Acc Military Mtf | Clinic/Center | 1999 Fisher Ave, Fort Indiantown Gap, Annville, PA 17003 | 2007-05-16 |
| 1235345935 | Kimbrough Acc Military Mtf | Clinic/Center | Letterkenny Army Depot, Bldg 332, Chambersburg, PA 17201 | 2007-05-16 |
| 1215134747 | Branch Medical Clinic Mechanicsburg | Clinic/Center | 5450 Carlisle Pike, Bldg 23a, Mechanicsburg, PA 17050-2411 | 2007-06-28 |
| 1174728414 | Kimbrough Acc Military Mtf | Clinic/Center | 450 Gibner Rd, Usadc, Carlisle Barracks, PA 17013-5003 | 2007-06-18 |
| 1225243181 | Keller Army Community Hospital | Clinic/Center | 11 Hap Arnold Blvd, Tobyhanna, PA 18466-5002 | 2007-05-14 |
| City | PHILADELPHIA |
| Zip Code | 19112 |
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| 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.