1841380367 NPI number — CHILDREN'S HOSPITAL OF PHILADELPHIA

Table of content: (NPI 1841380367)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841380367 NPI number — CHILDREN'S HOSPITAL OF PHILADELPHIA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHILDREN'S HOSPITAL OF PHILADELPHIA
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:
1841380367
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
301 LINDENWOOD DR
Provider Second Line Business Mailing Address:
SUITE 350
Provider Business Mailing Address City Name:
MALVERN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19355-1758
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-590-2897
Provider Business Mailing Address Fax Number:
215-590-0325

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
722 YORKLYN RD STE 100
Provider Second Line Business Practice Location Address:
STONE MILL OFFICE PARK.
Provider Business Practice Location Address City Name:
HOCKESSIN
Provider Business Practice Location Address State Name:
DE
Provider Business Practice Location Address Postal Code:
19707-8746
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
302-235-1188
Provider Business Practice Location Address Fax Number:
302-239-2604
Provider Enumeration Date:
10/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
TODOROW
Authorized Official First Name:
THOMAS
Authorized Official Middle Name:
Authorized Official Title or Position:
VP FINANCE
Authorized Official Telephone Number:
267-426-6940

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0000884302 , issued by the state of ( DE ) . This identifiers is of the category "MEDICAID".




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