NPIMap

Organization Active NPI

Branch Medical Clinic Philadelphia

  • Military/U.S. Coast Guard Outpatient Clinic/Center
  • Philadelphia, PA
National Provider Identifier
1609381623
Registry record updated Dec 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Military/U.S. Coast Guard Outpatient Clinic/CenterTaxonomy code 261QM1100X
Legal business name
BRANCH MEDICAL CLINIC PHILADELPHIA
Practice address
4898 S Broad St
Philadelphia, PA 19112-1320
Phone
(215) 897-8147
NPI assigned
Dec 13, 2017
Organization subpart
Yes
Parent organization
NAVAL HEALTH CLINIC ANNAPOLISAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 13, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
William M Condon
Title
Bumed Ubo
Phone
(240) 401-3643

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Military/U.S. Coast Guard Outpatient Clinic/Center 261QM1100X Primary

Addresses

Primary practice location

4898 S Broad St
Philadelphia, PA 19112-1320

Mailing address

250 Wood Rd
Annapolis, MD 21402-1257

National Provider Directory

National Provider Directory
Tax ID family
Branch Medical Clinic Lakehurst9 organizations share this tax ID, including this one
Part of
Branch Medical Clinic Lakehurst

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4898 S Broad St
Philadelphia, PA 19112
Phone (215) 897-8147

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1513123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1513123200000",
    "number": "1609381623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 WOOD RD",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214021257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4898 S BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191121320",
            "telephone_number": "215-897-8147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRANCH MEDICAL CLINIC PHILADELPHIA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NAVAL HEALTH CLINIC ANNAPOLIS",
        "enumeration_date": "2017-12-13",
        "last_updated": "2017-12-13",
        "status": "A",
        "authorized_official_last_name": "CONDON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "BUMED UBO",
        "authorized_official_telephone_number": "240-401-3643"
    },
    "taxonomies": [
        {
            "code": "261QM1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Military/U.S. Coast Guard Outpatient",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.