1548379993 NPI number — UNIV OF PENN - HYPERBARIC

Table of content: (NPI 1548379993)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548379993 NPI number — UNIV OF PENN - HYPERBARIC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNIV OF PENN - HYPERBARIC
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:
Provider Other Organization Name Type Code:
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:
1548379993
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/12/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3620 HAMILTON WALK
Provider Second Line Business Mailing Address:
1 JOHN MORGAN BUILDING
Provider Business Mailing Address City Name:
PHILADELPHIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19104-4215
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-898-9095
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3620 HAMILTON WALK
Provider Second Line Business Practice Location Address:
1 JOHN MORGAN BUILDING
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19104-4215
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-898-9095
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/30/2006

Additional Information

Authorized Official

Authorized Official Last Name:
JOHNSTON
Authorized Official First Name:
ELIZABETH
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
215-662-7583

Provider Taxonomy Codes

  • Taxonomy code: 207PE0005X , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207PH0002X , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RP1001X , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2083P0011X , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 07417 . This is a "HEALTHPARTNERS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 147708 . This is a "BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 3485013 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 487202200 . This is a "ACS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0016106680 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0054421000 . This is a "KEYSTONE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 32901 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: CF8179 . This is a "RR MEDICARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 273291 . This is a "MAMSI" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0002Y21654 . This is a "HEALTHNET" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1008376 . This is a "MERCY" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 203664 . This is a "EEIOC" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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