NPI 1134663024

Men Makers LLC

Organisation Exclusive Provider Organization Philadelphia, PA

Practice location

Address: 301 Cobbs Creek Pkwy, Philadelphia, PA 19143-1016
Phone: (267) 242-0939
Fax: (215) 474-5098

Authorised official

Name: Bernard Shemaiah Collins
Title: Executive Director
Phone: (267) 242-0939

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X Licence BH001116 (PA)

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Registry record

NPI: 1134663024
Entity type: Organization
NPI issued: 12 Dec 2016
Record last updated: 12 Dec 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.