Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Penncare-J Edwin Wood Clinic

Organization Non-Pharmacy Dispensing Site · NPI 1104967918

Penncare-J Edwin Wood Clinic is a Non-Pharmacy Dispensing Site in Philadelphia, Pennsylvania. Licensed in Pennsylvania. Registered with an NPI since 2007.

Licensed in
PA
In the registry since
2007

Practice location Address checks out

700 Spruce St 304
Philadelphia, PA 19106-4022
Phone: (215) 829-3532
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Non-Pharmacy Dispensing Site (primary) Taxonomy 332900000X · Licence OS012672 (PA)

Record details

NPI number1104967918
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationMedvantx, Inc
Authorized official Kenny Heine — Director Of Operations · (858) 625-2990
NPI enumeratedFebruary 12, 2007
Last updated in NPPESDecember 4, 2012
Mailing address5626 Oberlin Dr, Suite 110, San Diego, CA 92121-1705

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