Provider Demographics
NPI:1033435060
Name:TEMPLE UNIVERSITY HOSPITAL, INC
Entity Type:Organization
Organization Name:TEMPLE UNIVERSITY HOSPITAL, INC
Other - Org Name:TEMPLE UNIVERSITY HOSPITAL, INC D/B/A TEMPLE HEALTH SYSTEM TRANSPORT T
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:CHABALOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-707-3743
Mailing Address - Street 1:3401 N BROAD ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19140-5103
Mailing Address - Country:US
Mailing Address - Phone:215-707-2000
Mailing Address - Fax:
Practice Address - Street 1:100 E LEHIGH AVENUE
Practice Address - Street 2:BEACON HOUSE, LOWER LEVEL
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19125-1098
Practice Address - Country:US
Practice Address - Phone:215-707-6729
Practice Address - Fax:215-707-0618
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TEMPLE UNIVERSITY HOSPITAL, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-04-15
Last Update Date:2010-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA2007013416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA390027Medicare UPIN