Provider Demographics
NPI:1689049348
Name:TEMPLE UNIVERSITY HOSPITAL
Entity Type:Organization
Organization Name:TEMPLE UNIVERSITY HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM COORDINATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:
Authorized Official - Last Name:WENT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-707-5978
Mailing Address - Street 1:3400 N BROAD ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19140-5104
Mailing Address - Country:US
Mailing Address - Phone:215-707-3397
Mailing Address - Fax:
Practice Address - Street 1:3400 N BROAD ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19140-5104
Practice Address - Country:US
Practice Address - Phone:215-707-5978
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-07
Last Update Date:2015-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA197026281P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes281P00000XHospitalsChronic Disease Hospital