St Monica Manor

Primary specialty

Parenteral & Enteral Nutrition Supplies (DME)Taxonomy code 332BP3500X

License

232602 Issued in PA

Legal business name

ST MONICA MANOR

Practice address

2509 S 4TH St
Philadelphia, PA 19148-4712

Phone

(215) 271-1080

Fax

(215) 368-5254

NPI assigned

Nov 29, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Michael Czekner

Title

Chief Financial Officer

Phone

(215) 368-0900

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1780751123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2509 S 4TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191484712",
            "telephone_number": "215-271-1080",
            "fax_number": "215-368-5254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2509 S 4TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191484712",
            "telephone_number": "215-271-1080",
            "fax_number": "215-368-5254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST MONICA MANOR",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CZEKNER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "215-368-0900",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "PA",
            "license": "232602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NSC DME SUPPLIER #",
            "identifier": "5329640001",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• St John Neumann Nursing Home
• St John Neumann Nursing Home
• Kelly St John, RD, CSO, LDN
• Mary St Ledger, NP
• St Lukes Hospital
• St Monica Manor
• Ciarah St Paul, MD
• Emma Dionne St Raymond, MD
• Line St-Vil
• St. Agnes Continuing Care Center

• Parenteral & Enteral Nutrition Supplies (DME) in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Parenteral & Enteral Nutrition Supplies (DME) in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.