1114959582 NPI number — TENET HEALTHSYSTEM ST. CHRISTOPHER'S HOSPITAL FOR CHILDREN, LLC

Table of content: (NPI 1114959582)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114959582 NPI number — TENET HEALTHSYSTEM ST. CHRISTOPHER'S HOSPITAL FOR CHILDREN, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TENET HEALTHSYSTEM ST. CHRISTOPHER'S HOSPITAL FOR CHILDREN, LLC
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:
6
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:
1114959582
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/15/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 828125
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PHILADELPHIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19182-8125
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-255-3152
Provider Business Mailing Address Fax Number:
215-427-5555

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
ERIE AVENUE @ FRONT ST.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19134-1095
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-427-5000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/07/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ARMIN
Authorized Official First Name:
CRAIG
Authorized Official Middle Name:
C.
Authorized Official Title or Position:
VP OF GOVT PROGRAMS, TENET
Authorized Official Telephone Number:
818-436-2267

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QA1903X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 282NC2000X , with the licence number: 195601 , 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: 019369900 , issued by the state of ( DC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1007296720002 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 75-2522262 . This is a "BETTER HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 003114767 , issued by the state of ( CT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 64872238 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: HSP231515 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: STC00301N , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100470930 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1007296720007 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2311 . This is a "INDEPENDENCE BLUE CROSS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 00017 . This is a "HEALTH PARTNERS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4660903 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1007296720010 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 378638200 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4660897 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7009461 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000757589Y , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 00757589X , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 393307 . This is a "HORIZON NJ-BCBS HEALTH" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com