Basic Information
| Provider Information | |||||||||
| NPI: | 1033435060 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | TEMPLE UNIVERSITY HOSPITAL, INC | ||||||||
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| OtherOrganizationName: | TEMPLE UNIVERSITY HOSPITAL, INC D/B/A TEMPLE HEALTH SYSTEM TRANSPORT T | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3401 N BROAD ST | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191405103 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2157072000 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 100 E LEHIGH AVENUE | ||||||||
| Address2: | BEACON HOUSE, LOWER LEVEL | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191251098 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2157076729 | ||||||||
| FaxNumber: | 2157070618 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/15/2010 | ||||||||
| LastUpdateDate: | 04/15/2010 | ||||||||
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| AuthorizedOfficialLastName: | CHABALOWSKI | ||||||||
| AuthorizedOfficialFirstName: | EDWARD | ||||||||
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| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 2157073743 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | TEMPLE UNIVERSITY HOSPITAL, INC | ||||||||
| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 3416L0300X | 200701 | PA | Y | Transportation Services | Ambulance | Land Transport |
No ID Information.