Basic Information
| Provider Information | |||||||||
| NPI: | 1588963318 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | THE CHILDRENS HOSPITAL OF PHILADELPHIA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 115 WHITE OWL TRL | ||||||||
| Address2: | |||||||||
| City: | MULLICA HILL | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080621869 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8563430161 | ||||||||
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| Practice Location | |||||||||
| Address1: | 34 STREET AND CIVIC CENTER BOULEVARD | ||||||||
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| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191044399 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2155901000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/18/2011 | ||||||||
| LastUpdateDate: | 03/18/2011 | ||||||||
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| AuthorizedOfficialLastName: | SMITH | ||||||||
| AuthorizedOfficialFirstName: | THERESA | ||||||||
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| AuthorizedOfficialTitleorPosition: | FINANCIAL COORDINATOR | ||||||||
| AuthorizedOfficialTelephone: | 2159778100 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282NC2000X | MT191916 | PA | Y | Hospitals | General Acute Care Hospital | Children |
No ID Information.