PEDIATRIC HEALTH CARE ALLIANCE, PA
QID Q135411826 · NPI 1902572779
| Fact | Value | Period | Source |
|---|---|---|---|
| enumeration_date | {"date": "2021-08-20"} | 2021-08-20 | cms_nppes |
| legal_address | {"city": "APOLLO BEACH", "region": "FL", "street": "116 HARBOR VILLAGE LN", "country": "US | cms_nppes | |
| legal_name | {"value": "PEDIATRIC HEALTH CARE ALLIANCE, PA"} | cms_nppes | |
| provider_status | {"value": "aktiv", "deactivation_date": null, "reactivation_date": null} | cms_nppes | |
| provider_taxonomy | {"value": "208000000X", "scheme": "NUCC"} | cms_nppes |
Cite as: FACTANKER, https://factanker.com/entity/df2ffad4-6d03-45d9-bb15-59835280eb14