Provider Demographics
NPI:1275682148
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:
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:2007-01-09
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA200701261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0158198701OtherAMERICHOICE
390027OtherTRICARE
PA4570OtherIBC KHPE
1401OtherAETNA
11OtherELDERHEALTH
390027OtherPRIVATE HEALTHCARE
NJ60027OtherHORIZON NJ
PA1007351140006Medicaid
390027OtherCIGNA
390027OtherUNITED HEALTHCARE
390027OtherDEVON
390027OtherHEALTH AMERICA
PA60027OtherKEYSTONE MERCY
PA00018OtherHEALTH PARTNERS
390027OtherGEISINGER
390027OtherGEISINGER