Provider Demographics
NPI:1619182003
Name:HOLY REDEEMER HEALTH SYSTEM
Entity Type:Organization
Organization Name:HOLY REDEEMER HEALTH SYSTEM
Other - Org Name:PEDIATRIC REHAB
Other - Org Type:Other Name
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KEEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-856-1114
Mailing Address - Street 1:1648 HUNTINGDON PIKE
Mailing Address - Street 2:
Mailing Address - City:MEADOWBROOK
Mailing Address - State:PA
Mailing Address - Zip Code:19046-8001
Mailing Address - Country:US
Mailing Address - Phone:215-947-3000
Mailing Address - Fax:215-856-1060
Practice Address - Street 1:1648 HUNTINGDON PIKE
Practice Address - Street 2:
Practice Address - City:MEADOWBROOK
Practice Address - State:PA
Practice Address - Zip Code:19046-8001
Practice Address - Country:US
Practice Address - Phone:215-947-3000
Practice Address - Fax:215-856-1060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-11
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA390097Medicare ID - Type Unspecified