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

Vine Street Medical and Associates

Organization Addiction Medicine (Family Medicine) Physician · NPI 1861921389

Vine Street Medical and Associates is an Addiction Medicine (Family Medicine) Physician in Philadelphia, Pennsylvania. Licensed in Pennsylvania. Registered with an NPI since 2017.

Licensed in
PA
In the registry since
2017

Practice location Address checks out

6323 Vine St
Philadelphia, PA 19139-1032
Phone: (267) 292-5638
Fax: (267) 292-5648
Show map & directions

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

Specialties & licences

Addiction Medicine (Family Medicine) Physician (primary) Taxonomy 207QA0401X · Licence MD032595E (PA)

Record details

NPI number1861921389
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Shari Johnson — Admin · (267) 292-5638
NPI enumeratedJune 8, 2017
Last updated in NPPESSeptember 11, 2025
Mailing address6323 Vine St, Philadelphia, PA 19139-1032

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