OrganizationActive
Vine Street Medical and Associates
NPI 1861921389 · Addiction Medicine (Family Medicine) Physician · Philadelphia, PA
Provider details
- NPI number
- 1861921389
- Entity type
- Organization
- Primary specialty
- Addiction Medicine (Family Medicine) PhysicianAllopathic & Osteopathic Physicians
- Authorized official
- Shari Johnson, Admin
- License
- MD032595E (PA)
Practice location
6323 Vine St
Philadelphia, PA 19139-1032
Phone: (267) 292-5638
Fax: (267) 292-5648
Mailing address
6323 Vine St
Philadelphia, PA 19139-1032
Registry dates
- Enumerated
- 2017-06-08
- Last updated
- 2025-09-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.