Provider Demographics
NPI:1003979824
Name:TEMPLE UNIVERSITY HOSPITAL, INC
Entity Type:Organization
Organization Name:TEMPLE UNIVERSITY HOSPITAL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO AND VP
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:LUX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-707-3802
Mailing Address - Street 1:3401 N BROAD ST
Mailing Address - Street 2:
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19140-5103
Mailing Address - Country:US
Mailing Address - Phone:215-707-5303
Mailing Address - Fax:215-707-8998
Practice Address - Street 1:3401 N BROAD ST
Practice Address - Street 2:
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19140-5103
Practice Address - Country:US
Practice Address - Phone:215-707-5303
Practice Address - Fax:215-707-8998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA200701273Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
390027OtherDEVON
1401OtherAETNA
390027OtherCIGNA
390027OtherHEALTH AMERICA
PA60027OtherKEYSTONE MERCY
PA00018OtherHEALTH PARTNERS
PA0158198701OtherAMERICHOICE
390027OtherCHAMPUS TRICARE
PA1007351140005Medicaid
390027OtherPRIVATE HEALTHCARE
390027OtherUNITED HEALTHCARE
PA4570OtherIBC KHPE
390027OtherGEISINGER
NJ60027OtherHORIZON NJ
11OtherELDERHEALTH
390027OtherGEISINGER