PENNCARE-J. EDWIN WOOD CLINIC
NPI 1104967918
Non-Pharmacy Dispensing Site in Philadelphia, PA

Q: What is Penncare-J. Edwin Wood Clinic's NPI number?

The NPI number for Penncare-J. Edwin Wood Clinic is 1104967918. It was assigned to this organization in the NPPES registry on February 12, 2007.

Q: What is Penncare-J. Edwin Wood Clinic's specialty?

The primary specialty registered for this NPI is Non-Pharmacy Dispensing Site with taxonomy code 332900000X.

Active since February 12, 2007

700 SPRUCE ST, 304, PHILADELPHIA, PA 19106(215) 829-3532 Get Directions Write a Review

NPPES record last updated: December 4, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Penncare-j. Edwin Wood Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PENNCARE-J. EDWIN WOOD CLINIC (NPI 1104967918) is a healthcare organization registered as a non-pharmacy dispensing site in Philadelphia, Pennsylvania and active in the NPI registry since February 2007. The organization lists Kenny Heine, Director Of Operations, as its authorized official.

NPPES Registry Identity

NPI1104967918

Entity TypeOrganization

Primary Taxonomy332900000X

Legal Business NamePENNCARE-J. EDWIN WOOD CLINIC

Location Address700 SPRUCE ST, 304Philadelphia, PA 19106-4022

Mailing Address5626 Oberlin Dr, Suite 110San Diego, CA 92121-1705

Phone(215) 829-3532

Organization SubpartYesParent: Medvantx, Inc.

Authorized OfficialKenny HeineDirector Of Operations · (858) 625-2990

Enumeration DateFebruary 12, 2007

Last NPPES UpdateDecember 4, 2012

✔ NPI 1104967918 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNon-Pharmacy Dispensing SiteSuppliers

Taxonomy Code332900000X

License✔ Licensed in PA · OS012672

Definition

A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)

700 SPRUCE ST, Philadelphia, PA 19106

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TERESE HETHERINGTON CRNP

Nurse Practitioner (Family)

700 SPRUCE ST, STE. 304
PHILADELPHIA, PA 19106

Philadelphia County (215) 829-3521

DR. MICHAEL P CASEY M.D.

Internal Medicine (Pulmonary Disease)

700 SPRUCE ST
PHILADELPHIA, PA 19106

Philadelphia County (215) 829-5027

FAY D WRIGHT MD

Obstetrics & Gynecology

700 SPRUCE ST, SUITE 200
PHILADELPHIA, PA 19106

Philadelphia County (215) 889-5025

DR. MATTHEW JOSEPH DOUGHERTY

Surgery (Vascular Surgery)

700 SPRUCE ST, STE 101
PHILADELPHIA, PA 19106

Philadelphia County (215) 829-5000

KATHRYN M DOSHI PA-C

Physician Assistant (Medical)

700 SPRUCE ST, PINE BASEMENT WEST
PHILADELPHIA, PA 19106

Philadelphia County (215) 829-3264

DR. KEITH DON CALLIGARO MD

Surgery (Vascular Surgery)

700 SPRUCE ST, STE 101
PHILADELPHIA, PA 19106

Philadelphia County (215) 829-5000

KEVIN RICHARD KLINE MD

Family Medicine

700 SPRUCE ST, SUITE #305
PHILADELPHIA, PA 19106

Philadelphia County (215) 829-3468

TIMOTHY ROBERTS PA-C

Physician Assistant

700 SPRUCE ST, PINE BASEMENT WEST
PHILADELPHIA, PA 19106

Philadelphia County (215) 829-3264

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Penncare-J. Edwin Wood Clinic's NPI number?

The NPI number for Penncare-J. Edwin Wood Clinic is 1104967918. It was assigned to this organization in the NPPES registry on February 12, 2007.

Where is Penncare-J. Edwin Wood Clinic located?

Penncare-J. Edwin Wood Clinic is located at 700 Spruce St 304, Philadelphia, PA 19106. The listed phone number is (215) 829-3532.

What is Penncare-J. Edwin Wood Clinic's specialty?

The primary specialty registered for this NPI is Non-Pharmacy Dispensing Site with taxonomy code 332900000X.

When was this NPI record last updated?

The NPPES record for Penncare-J. Edwin Wood Clinic was last updated on December 4, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.