Provider Demographics
NPI:1447307517
Name:SCHOOL DISTRICT OF PHILADELPHIA
Entity type:Organization
Organization Name:SCHOOL DISTRICT OF PHILADELPHIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIN SVCS DIR, ACCESS PROGRAM
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:OVINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-400-5476
Mailing Address - Street 1:440 N BROAD ST
Mailing Address - Street 2:3RD FLOOR - SUITE 323
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19130-4015
Mailing Address - Country:US
Mailing Address - Phone:215-400-4580
Mailing Address - Fax:215-400-4582
Practice Address - Street 1:440 N BROAD ST
Practice Address - Street 2:3RD FLOOR - SUITE 323
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19130-4015
Practice Address - Country:US
Practice Address - Phone:215-400-4580
Practice Address - Fax:215-400-4582
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1001373210092Medicaid