Provider Demographics
NPI:1639640600
Name:CHILDREN'S HOSPITAL OF PHILADELPHIA
Entity Type:Organization
Organization Name:CHILDREN'S HOSPITAL OF PHILADELPHIA
Other - Org Name:CHOP POISON CONTROL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING AND RESPONSE SPECIALI
Authorized Official - Prefix:
Authorized Official - First Name:GALENA
Authorized Official - Middle Name:
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-590-2897
Mailing Address - Street 1:3401 CIVIC CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-4319
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3401 CIVIC CENTER BLVD STE 7471
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4319
Practice Address - Country:US
Practice Address - Phone:215-590-2003
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHILDREN'S HOSPITAL OF PHILADELPHIA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-12-17
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency MedicineGroup - Multi-Specialty
No2080T0002XAllopathic & Osteopathic PhysiciansPediatricsMedical ToxicologyGroup - Multi-Specialty
No2083T0002XAllopathic & Osteopathic PhysiciansPreventive MedicineMedical ToxicologyGroup - Multi-Specialty