Provider Demographics
NPI:1518000686
Name:ALBERT EINSTEIN MEDICAL CENTER
Entity Type:Organization
Organization Name:ALBERT EINSTEIN MEDICAL CENTER
Other - Org Name:EINSTEIN APOTHECARY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:NETWORK DIR OF PHCY
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:HAUSER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH, MHA
Authorized Official - Phone:215-456-7880
Mailing Address - Street 1:5501 OLD YORK RD
Mailing Address - Street 2:LEVY BLDG 1ST FL
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19141-3018
Mailing Address - Country:US
Mailing Address - Phone:215-456-7880
Mailing Address - Fax:215-456-7980
Practice Address - Street 1:5501 OLD YORK RD
Practice Address - Street 2:LEVY BLDG 1ST FL
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19141-3018
Practice Address - Country:US
Practice Address - Phone:215-456-7880
Practice Address - Fax:215-456-7980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0003X
PAPP4813613336I0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336I0012XSuppliersPharmacyInstitutional Pharmacy
No333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2116538OtherPK
PA1007544140015Medicaid
PA1007544140099Medicaid
PA1007544140099Medicaid