Type 2 · Organization ✓ Active NPI ✓ Valid NPI checksum Organization subpart

Penncare-J. Edwin Wood Clinic

Q: What is the NPI number for Penncare-J. Edwin Wood Clinic?

The NPI for Penncare-J. Edwin Wood Clinic is 1104967918, a Type 2 (organization) record in the CMS NPPES registry.

Non-Pharmacy Dispensing Site in Philadelphia, PA · enumerated 2007 · authorized official Kenny Heine, Director of Operations.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1104967918

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Registry record

Entity type Organization (Type 2)

Legal business name Penncare-J. Edwin Wood Clinic

Parent organization Medvantx, Inc.

Practice address 700 Spruce St, 304, Philadelphia, PA, 19106

Phone (215) 829-3532

Enumeration date Feb 12, 2007

Last updated in NPPES Dec 4, 2012

Taxonomy & classification

332900000X Non-Pharmacy Dispensing Site Suppliers · License OS012672 (PA) Primary

Authorized official

Name Kenny Heine

Title Director of Operations

Phone (858) 625-2990

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

Read the full guide → Validate an NPI →

Frequently asked questions

What is the NPI number for Penncare-J. Edwin Wood Clinic?

The NPI for Penncare-J. Edwin Wood Clinic is 1104967918, a Type 2 (organization) record in the CMS NPPES registry.

Who is the authorized official for Penncare-J. Edwin Wood Clinic?

NPPES lists Kenny Heine (Director of Operations) as the authorized official for this organization.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2012-12-04.