1124495833 NPI number — TEMPLE PHYSICIANS INC

Table of content: (NPI 1124495833)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124495833 NPI number — TEMPLE PHYSICIANS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TEMPLE PHYSICIANS INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
TEMPLE INTERNAL MEDICINE BURHOLME
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1124495833
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/28/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7500 CENTRAL AVE
Provider Second Line Business Mailing Address:
SUITE 202
Provider Business Mailing Address City Name:
PHILADELPHIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19111-2430
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-742-5099
Provider Business Mailing Address Fax Number:
215-742-0665

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7500 CENTRAL AVE
Provider Second Line Business Practice Location Address:
SUITE 202
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19111-2430
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-742-5099
Provider Business Practice Location Address Fax Number:
215-742-0665
Provider Enumeration Date:
08/28/2015

Additional Information

Authorized Official

Authorized Official Last Name:
SAVERING
Authorized Official First Name:
LYNNIE
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR PATIENT ACCOUNTING
Authorized Official Telephone Number:
215-926-9015

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207RG0300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363AM0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LA2200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 100727800 . This is a "TPI MEDICAID" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: CD4829 . This is a "RAILROADMEDICARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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