1467589218 NPI number — MAIN LINE HOSPITALS, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467589218 NPI number — MAIN LINE HOSPITALS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MAIN LINE HOSPITALS, 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:
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:
1467589218
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/12/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
240 N RADNOR CHESTER RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RADNOR
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19087-5170
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
484-337-1814
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
130 S BRYN MAWR AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BRYN MAWR
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19010-3121
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-526-3000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/28/2007

Additional Information

Authorized Official

Authorized Official Last Name:
EHRLICH
Authorized Official First Name:
LEIGH
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF FINANCIAL OFFICER
Authorized Official Telephone Number:
484-337-2029

Provider Taxonomy Codes

  • Taxonomy code: 261QA1903X , with the licence number:  280701 , 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: 1007354280002 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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