NPIMap

Organization Active NPI

City of Philadelphia

Doing business as Phila Health Dept Laboratory

  • Clinical Medical Laboratory
  • Phila, PA
National Provider Identifier
1689688798
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
39D0657854 Issued in PA
Legal business name
CITY OF PHILADELPHIA
Doing business as
Phila Health Dept Laboratory
Practice address
500 S Broad St FL 3
Phila, PA 19146
Phone
(215) 685-6812
NPI assigned
Jul 27, 2006
Last updated
Jun 11, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Authorized official

Name
Christine Gaddy
Title
Billing Manager
Phone
(215) 685-6843

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 39D0657854 PA Primary

Addresses

Primary practice location

500 S Broad St FL 3
Phila, PA 19146

Mailing address

1101 Market St FL 10
Philadelphia, PA 19107-2911
Phone (215) 685-5306

Other names 2

  • PHILA HEALTH DEPT LABORATORY Doing business as
  • CITY OF PHILADELPHIA Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180530001164 PA Part B Supplier - Independent Clinical Laboratory 6305758723 Practice locations: Philadelphia, PA

Other NPIs with the same Medicare PAC ID 9

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Health Center No 523 organizations share this tax ID, including this one

Other organizations with this tax ID 22

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

View all 22

Locations (25 of 30)

23 W City Ave
Bala Cynwyd, PA 19004
Phone (610) 617-8500

145 W Tioga St
Phila, PA 19140
Phone (215) 634-1800

167 W Allegheny Ave
Phila, PA 19140
Phone (215) 423-3070

1719 Morris St
Phila, PA 19145
Phone (215) 334-2312

3301 S 20th St
Phila, PA 19145
Phone (215) 462-2822

4801 N Mascher St
Phila, PA 19120
Phone (215) 455-3531

5415 Rising Sun Ave
Phila, PA 19120
Phone (215) 407-8364

603 E Sedgwick St
Phila, PA 19119
Phone (215) 248-3433

6161 N 5th St
Phila, PA 19120
Phone (215) 424-1300

6376 City Ave
Phila, PA 19151
Phone (215) 877-2744

87 E Haines St
Phila, PA 19144
Phone (215) 844-0954

1127 W Loudon St
Philadelphia, PA 19141
Phone (215) 685-9198

1700 S Broad St
Apt 201
Philadelphia, PA 19145
Phone (215) 685-1800

1900 N 20th St
#5
Philadelphia, PA 19121
Phone (215) 685-2933

1930 S Broad St
Unit 2
Philadelphia, PA 19145
Phone (215) 467-5870

2110 Market St
Philadelphia, PA 19103
Phone (215) 686-9958

2426 N 2nd St
Philadelphia, PA 19133
Phone (215) 685-9846

3031 Grays Fry Ave
City of Philadelphia Fire Dept
Philadelphia, PA 19146
Phone (215) 685-1790

3270 Comly Rd
Philadelphia, PA 19154
Phone (215) 685-9374

3420 Haverford Ave
Philadelphia, PA 19104
Phone (215) 685-7698

4700 Springfield Ave
Philadelphia, PA 19143
Phone (215) 727-0100

500 S Broad St
Fl 3
Philadelphia, PA 19146
Phone (215) 685-6790

5627 Ridge Ave
Philadelphia, PA 19128
Phone (215) 483-7522

5900 N 5th St
Philadelphia, PA 19120
Phone (215) 870-9349

5931 Old York Rd
Philadelphia, PA 19141
Phone (215) 685-2881

Ownership & related parties

All facility ownership & control disclosures 8

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Department of Public Health - Philadelphia District HC #2Philadelphia, PA, CCN 391872 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Feb 5, 2015
Department of Public Health - Strawberry Mansion Health CenterPhiladelphia, PA, CCN 391879 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Apr 1, 1985
Department of Public Health - Philadelphia District Health Center #10Philadelphia, PA, CCN 391878 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jan 2, 1976
Department of Public Health - Philadelphia District HC #9Philadelphia, PA, CCN 391877 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jul 1, 1966
Department of Public Health - Philadelphia District HC #6Philadelphia, PA, CCN 391876 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jan 2, 1984
Department of Public Health-Philadelphia District Health Center #4Philadelphia, PA, CCN 391874 Federally qualified health center Operational/Managerial Control Feb 24, 2011
Department of Public Health-Philadelphia District HC #5Philadelphia, PA, CCN 391875 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jan 2, 1980
Department of Public Health - Philadelphia District Health Center #3Philadelphia, PA, CCN 391873 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) May 15, 2015

Owned or controlled facilities with NPI records 8

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • City of Philadelphia

    dba Health Care Center 6

    • Federally Qualified Health Center (FQHC)
    • Philadelphia, PA
    • NPI 1023125085

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • City of Philadelphia

    dba Health Care Center 4

    • Federally Qualified Health Center (FQHC)
    • Philadelphia, PA
    • NPI 1144337189

    Operational/Managerial Control

    CMS ownership
  • City of Philadelphia

    dba Strawberry Mansion Health Center

    • Federally Qualified Health Center (FQHC)
    • Philadelphia, PA
    • NPI 1417064353

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • City of Philadelphia

    dba Health Care Center 9

    • Federally Qualified Health Center (FQHC)
    • Philadelphia, PA
    • NPI 1427165307

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • City of Philadelphia

    dba Health Care Center 5

    • Federally Qualified Health Center (FQHC)
    • Philadelphia, PA
    • NPI 1518074566

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • City of Philadelphia

    dba Health Center 10

    • Federally Qualified Health Center (FQHC)
    • Philadelphia, PA
    • NPI 1699882597

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • City of Philadelphia

    dba Health Care Center 3

    • Federally Qualified Health Center (FQHC)
    • Philadelphia, PA
    • NPI 1740397769

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • City of Philadelphia

    dba Health Care Center 2

    • Federally Qualified Health Center (FQHC)
    • Philadelphia, PA
    • NPI 1942317094

    5% Or Greater Direct Ownership Interest

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 165

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 165

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1689688798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 MARKET ST FL 10",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191072911",
            "telephone_number": "215-685-5306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S BROAD ST FL 3",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "19146",
            "telephone_number": "215-685-6812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF PHILADELPHIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-27",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "GADDY",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "215-685-6843"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PA",
            "license": "39D0657854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PHILA HEALTH DEPT LABORATORY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CITY OF PHILADELPHIA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Phila, PA

Sources for this page

Verify at the official NPI Registry.