1821296534 NPI number — TEMPLE UNIVERSTIY HOSPITAL

Table of content: (NPI 1821296534)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821296534 NPI number — TEMPLE UNIVERSTIY HOSPITAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TEMPLE UNIVERSTIY HOSPITAL
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:
1821296534
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/23/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
24 BLACKWELL LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WILLINGBORO
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08046-3907
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
609-871-2454
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7604 CENTRAL AVE, FRIENDS HALL PHYSICIANS BUILDING,
Provider Second Line Business Practice Location Address:
JEANES HOSP.
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19111-2442
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-214-3100
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/03/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MANGAN
Authorized Official First Name:
KENNETH
Authorized Official Middle Name:
FRANCIS
Authorized Official Title or Position:
SECTION CHIEF
Authorized Official Telephone Number:
215-214-3100

Provider Taxonomy Codes

  • Taxonomy code: 261QX0200X , with the licence number:  SP007236 , 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)