HR Physician Services
Organization Active NPI Internal Medicine Physician · Philadelphia, PA
NPI 1174073563 · NPPES record last updated Oct 10, 2016
Key facts
- NPI
- 1174073563
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- OS005558L (PA)
- Legal business name
- HR PHYSICIAN SERVICES
- Practice address
- 8580 Verree Rd
Philadelphia, PA 19111-1370 - Phone
- (215) 214-3815
- Fax
- (215) 214-3816
- NPI assigned
- Oct 10, 2016
- Organization subpart
- No
Authorized official
- Name
- Russell R Wagner
- Title
- Executive Vice President Finance
- Phone
- (215) 856-1114
Other NPIs on the same Medicare enrollment 40
Practitioners 1
-
Justin Hung Pham, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040311000028 | PA | Part B Supplier - Clinic/Group Practice | 0042109902 |
Receives reassigned benefits from 373 practitioners 40 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Philadelphia, PA; Meadowbrook, PA; Richboro, PA; Rockledge, PA; Southampton, PA; Warminster, PA; Warmister, PA; Willow Grove, PA… |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician |
207R00000X | OS005558L | PA | Yes |
Addresses
Primary practice location
8580 Verree Rd
Philadelphia, PA 19111-1370
Mailing address
12265 Townsend Rd
Philadelphia, PA 19154-1201
Phone (215) 856-1010
Other names
- REDEEMER RETIREMENT COMMUNITY PRIMARY CARE
Other providers in Philadelphia, PA
- Natasha N Hoyte
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- HR Physicians SVS
All providers in Philadelphia, PA · Internal Medicine Physician in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 10, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.