DELAWARE VALLEY COMMUNITY HEALTH, INC. (NPI# 1811202153) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811202153 |
| Entity Type | Organization |
| Organization Name | DELAWARE VALLEY COMMUNITY HEALTH, INC. |
| Other Organization Name | FAIRMOUNT PRIMARY CARE HEALTH CENTER AT HORIZON HOUSE |
| Practice Address |
120 S 30th St 2nd Floor Philadelphia PA 19104-3403 |
| Mailing Address |
1412 Fairmount Ave Philadelphia PA 19130-2908 |
| Practice Telephone | 2152222466 |
| Practice Fax Number | 2152222462 |
| Mailing Telephone | 2155994851 |
| Mailing Fax Number | 2152324093 |
| Enumeration Date | 2010-08-11 |
| Last Update Date | 2018-12-12 |
| Authorized Official Name | DR. ALVAN SCOTT MCNEAL JR. (PRESIDENT/CEO) |
| Authorized Official Telephone | 2156845344 |
| Authorized Official Credential | DO |
| Is Organization Subpart | Y |
| Parent Organization Name | DELAWARE VALLEY COMMUNITY HEALTH, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 100772996-0025 | 05 | |
| PA | MEDICARE | 391012 | 01 |
| Other Name | Type Code |
|---|---|
| Fairmount Primary Care Health Center at Horizon House | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225536568 | Delaware Valley Community Health, Inc. | Clinic/Center | 400 W Allegheny Ave Bldg 5b, Philadelphia, PA 19133-3639 | 2018-01-31 |
| 1538619333 | Delaware Valley Community Health, Inc. | Clinic/Center | 801 West Girard Avenue, Philadelphia, PA 19122-4212 | 2016-10-05 |
| 1114940582 | Delaware Valley Community Health, Inc. | Clinic/Center | 401 55 W Allegheny Ave, Philadelphia, PA 19133-3644 | 2006-07-25 |
| 1285699686 | Delaware Valley Community Health, Inc. | Clinic/Center | 1412-22 Fairmount Avenue, Philadelphia, PA 19130-2908 | 2006-04-19 |
| 1295279644 | Delaware Valley Community Health, Inc. | Clinic/Center | 800 Chester Pike, Sharon Hill, PA 19079-1400 | 2016-12-05 |
| 1073819967 | Delaware Valley Community Health, Inc. | Clinic/Center | 1600 W Girard Ave, Suite 201, Philadelphia, PA 19130-1615 | 2011-02-10 |
| 1720390933 | Delaware Valley Community Health, Inc. | Clinic/Center | 5000 Parkside Ave, Suite 100, Philadelphia, PA 19131-4714 | 2010-07-06 |
| 1689873911 | Delaware Valley Community Health, Inc. | Clinic/Center | 841 E Hunting Park Ave, Suite 201, Philadelphia, PA 19124-4800 | 2007-07-17 |
| 1386864502 | Delaware Valley Community Health, Inc. | Clinic/Center | 1412 Fairmount Ave, Philadelphia, PA 19130-2908 | 2007-04-27 |
| 1174545115 | Delaware Valley Community Health, Inc. | Clinic/Center | 1401 Dekalb St, Norristown, PA 19401-3405 | 2006-07-25 |
| Street Address |
120 S 30TH ST 2ND FLOOR |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19104-3403 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841377611 | Horizon House, Inc. | Community/Behavioral Health | 120 S 30th St, Ist Division, Philadelphia, PA 19104-3403 | 2006-11-01 |
| 1003114513 | Martha M. Dooley | Clinical Nurse Specialist | 120 S 30th St, 5th Floor, Philadelphia, PA 19104-3403 | 2011-03-08 |
| 1124297023 | House House Rehabilitation Services | Community/Behavioral Health | 120 S 30th St, Ist Division, Philadelphia, PA 19104-3403 | 2008-02-25 |
| 1760651657 | House House Rehabilitation Services | Community/Behavioral Health | 120 S 30th St, Ist Division, Philadelphia, PA 19104-3403 | 2008-02-25 |
| 1558578047 | Kristin Maria Vanzant | Psychiatry & Neurology | 120 S 30th St, Philadelphia, PA 19104-3403 | 2007-05-16 |
| 1457566606 | Ryan Joseph Clancy | Physician Assistant | 120 S 30th St, 2nd Floor, Philadelphia, PA 19104-3403 | 2007-05-11 |
| 1497875330 | Horizon House Developmental Services | Community/Behavioral Health | 120 S 30th St, Ist Division, Philadelphia, PA 19104-3403 | 2007-03-31 |
| 1497875348 | House House Rehabilitation Services | Case Management | 120 S 30th St, Ist Division, Philadelphia, PA 19104-3403 | 2007-03-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639770829 | Michelle Morris | Student in an Organized Health Care Education/Training Program | Dept. of Family Medicine & Community Health, 3737 Market, Philadelphia, PA 19104 | 2020-11-04 |
| 1346853041 | Spectrum Health Services, Inc. | Clinic/Center | 1415 South University Ave, Philadelphia, PA 19104 | 2020-08-24 |
| 1770104259 | Fatimah Sorefan-mangou | Student in an Organized Health Care Education/Training Program | 4 Maloney 3400 Spruce Street, Philadelphia, PA 19104 | 2020-05-06 |
| 1114548690 | Rebecca Blaguski | Registered Nurse | The Hospital of The University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104 | 2020-05-06 |
| 1952944175 | Rebecca Miriam Barmherzig | Psychiatry & Neurology | 3501 Civic Centre Blvd, 10th Flr Ctrb, Neurology, Philadelphia, PA 19104 | 2019-10-21 |
| 1891257101 | James Paul Byrne | Surgery | Penn Presbyterian Medical Center, Division of Trauma, S, 51 N. 39th Street, Suite 120, 1st Floor Medical Office, Philadelphia, PA 19104 | 2019-04-04 |
| 1093276453 | Lauren Shreve | Student in an Organized Health Care Education/Training Program | Department of Surgery, Surgery Education - Penn Health, 3400 Spruce Street, 4 Maloney, Philadelphia, PA 19104 | 2019-03-28 |
| 1285194282 | Lauren M Christie | Student in an Organized Health Care Education/Training Program | Penn Presbyterian Medical Center, 51 N. 39th Street, Philadelphia, PA 19104 | 2019-03-25 |
| 1114487683 | Sabrina Layne | Student in an Organized Health Care Education/Training Program | 3400 Spruce Street, 100 Centrex, Philadelphia, PA 19104 | 2019-03-21 |
| 1811457310 | Kia Lor | Student in an Organized Health Care Education/Training Program | Hospital of University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104 | 2019-03-21 |
| Find all providers in zip 19104 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346853041 | Spectrum Health Services, Inc. | Clinic/Center | 1415 South University Ave, Philadelphia, PA 19104 | 2020-08-24 |
| 1508478157 | Greater Philadelphia Health Action Incorporated | Clinic/Center | 2463 Emerald St, Philadelphia, PA 19125-1236 | 2020-08-17 |
| 1255943809 | Greater Philadelphia Health Action Incorporated | Clinic/Center | 3116 Frankford Ave, Philadelphia, PA 19134-3827 | 2020-08-17 |
| 1467063396 | Greater Philadelphia Health Action Incorporated | Clinic/Center | 1952 E Allegheny Ave, Philadelphia, PA 19134-3122 | 2020-08-13 |
| 1275151607 | Greater Philadelphia Health Action Incorporated | Clinic/Center | 1717 W Allegheny Ave, Philadelphia, PA 19132-1606 | 2020-07-13 |
| 1679133268 | Public Health Management Corporation | Clinic/Center | 315 S Broad St, Philadelphia, PA 19107-5213 | 2019-06-17 |
| 1821589615 | Covenant House, Inc | Clinic/Center | 2385 W Cheltenham Ave., Philadelphia, PA 19150 | 2018-05-29 |
| 1225536568 | Delaware Valley Community Health, Inc. | Clinic/Center | 400 W Allegheny Ave Bldg 5b, Philadelphia, PA 19133-3639 | 2018-01-31 |
| 1073037826 | Greater Philadelphia Health Action Inc. | Clinic/Center | 5630 Vine Street, Philadelphia, PA 19139-4703 | 2017-08-02 |
| 1225552177 | Greater Philadelphia Health Action Inc. | Clinic/Center | 3301 Tasker Street, Philadelphia, PA 19145-9996 | 2017-08-02 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19104 |
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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.