NPIMap

Organization Active NPI

Philadelphia Covid Center 1 LLC

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1912658121
Registry record updated Jan 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
PHILADELPHIA COVID CENTER 1 LLC
Practice address
842 Red Lion Rd Ste 13a
Philadelphia, PA 19115-1475
Phone
(215) 850-9594
NPI assigned
Jan 10, 2022
Last updated
Jan 10, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2022

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

Authorized official

Name
Inna Sandler, RPHNPI 1669165395
Title
Owner
Phone
(215) 850-9594

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

842 Red Lion Rd Ste 13a
Philadelphia, PA 19115-1475

Mailing address

842 Red Lion Rd Ste 13a
Philadelphia, PA 19115-1475

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL KoLIMS Health Information Exchange (HIE)

National Provider Directory

National Provider Directory
Tax ID family
Avon Discount Pharmacy LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1641772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641772800000",
    "number": "1912658121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "842 RED LION RD STE 13A",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191151475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "842 RED LION RD STE 13A",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191151475",
            "telephone_number": "215-850-9594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILADELPHIA COVID CENTER 1 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-10",
        "last_updated": "2022-01-10",
        "certification_date": "2022-01-10",
        "status": "A",
        "authorized_official_last_name": "SANDLER",
        "authorized_official_first_name": "INNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "215-850-9594",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "KoLIMS",
            "affiliation": "N",
            "endpointDescription": "EHR Program",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "842 Red Lion Rd Ste 13A",
            "city": "Philadelphia",
            "state": "PA",
            "country_code": "US",
            "postal_code": "191151475",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Jan 10, 2022; 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.