Provider Demographics
NPI:1023033792
Name:TENET HEALTH SYSTEM HAHNEMANN, LLC
Entity Type:Organization
Organization Name:TENET HEALTH SYSTEM HAHNEMANN, LLC
Other - Org Name:HAHNEMANN UNIVERSITY HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF GOVT PROGRAMS, TENET
Authorized Official - Prefix:MR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:C
Authorized Official - Last Name:ARMIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-436-2267
Mailing Address - Street 1:PO BOX 741230
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-1230
Mailing Address - Country:US
Mailing Address - Phone:215-255-3152
Mailing Address - Fax:215-762-8109
Practice Address - Street 1:BROAD & VINE STREETS
Practice Address - Street 2:MAILSTOP 417
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-1178
Practice Address - Country:US
Practice Address - Phone:215-762-7000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-13
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261Q00000X, 261QA1903X, 282NC0060X
PA081701282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
No282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
0002304OtherINDEPENDENCE BLUE CROSS
VA010045720Medicaid
SC10362AMedicaid
NJ8029300Medicaid
000402332OtherAETNA US HEALTHCARE (NATI
NC3900290Medicaid
FL911341000Medicaid
2304OtherAMERIHEALTH INC.
MD765124400Medicaid
DE0000977805Medicaid
00014OtherHEALTH PARTNERS
KY01570779Medicaid
DC019387700Medicaid
NY0199655Medicaid
OH0316250Medicaid
ALHOS00290NMedicaid
000419OtherHUMANA
CAXPHSP32790Medicaid
MD765124400Medicaid