Provider Demographics
NPI:1144379801
Name:TEMPLE UNIVERSITY HOSPITAL, INC
Entity Type:Organization
Organization Name:TEMPLE UNIVERSITY HOSPITAL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP AND CFO
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:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19140-5103
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3401 N BROAD ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19140-5103
Practice Address - Country:US
Practice Address - Phone:215-707-5303
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TEMPLE UNIVERSITY HOSPITAL, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-10
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA200701261QE0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0158198701OtherAMERICHOICE
11OtherELDERHEALTH
1401OtherAETNA
390027OtherGEISINGER
NJ60027OtherHORIZON NJ
PA00018OtherHEALTH PARTNERS
390027OtherDEVON
390027OtherUNITED HEALTHCARE
PA1007351140008Medicaid
390027OtherTRICARE
390027OtherCIGNA
390027OtherHEALTH AMERICA
390027OtherPRIVATE HEALTHCARE
PA60027OtherKEYSTONE MERCY
PA4570OtherIBC KHPE
390027OtherDEVON