Basic Information
| Provider Information | |||||||||
| NPI: | 1043487366 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | TEMPLE UNIVERSITY HOSPITAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1316 W ONTARIO ST | ||||||||
| Address2: | JONES HALL 9TH FLOOR | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191405220 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2157079403 | ||||||||
| FaxNumber: | 2152251698 | ||||||||
| Practice Location | |||||||||
| Address1: | 1316 W ONTARIO ST | ||||||||
| Address2: | JONES HALL 9TH FLOOR | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191405220 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2157079403 | ||||||||
| FaxNumber: | 2152251698 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/15/2008 | ||||||||
| LastUpdateDate: | 05/15/2008 | ||||||||
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| AuthorizedOfficialLastName: | WILSON | ||||||||
| AuthorizedOfficialFirstName: | DAWN | ||||||||
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| AuthorizedOfficialTitleorPosition: | CREDENTIALING MANAGER COGENT HEALTH | ||||||||
| AuthorizedOfficialTelephone: | 6153775670 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | CPMSM | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | MD433919 | PA | Y | Hospitals | General Acute Care Hospital |
No ID Information.