Provider Demographics
NPI:1053132282
Name:PERSONAL CARE HOME C&G MEDICAL CLINIC, PLLC
Entity type:Organization
Organization Name:PERSONAL CARE HOME C&G MEDICAL CLINIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:KARIMA
Authorized Official - Middle Name:
Authorized Official - Last Name:PARSON-WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-433-2366
Mailing Address - Street 1:4104 N 5TH ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19140-2614
Mailing Address - Country:US
Mailing Address - Phone:445-223-3812
Mailing Address - Fax:445-223-1770
Practice Address - Street 1:4104 N 5TH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19140-2614
Practice Address - Country:US
Practice Address - Phone:445-223-3812
Practice Address - Fax:445-223-1770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-21
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty