Provider Demographics
NPI:1821296534
Name:TEMPLE UNIVERSTIY HOSPITAL
Entity Type:Organization
Organization Name:TEMPLE UNIVERSTIY HOSPITAL
Other - Org Name:FOX CHASE TEMPLE BONE MARROW TRANSPLANT PROGRAM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECTION CHIEF
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:MANGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD, FACP
Authorized Official - Phone:215-214-3100
Mailing Address - Street 1:24 BLACKWELL LN
Mailing Address - Street 2:
Mailing Address - City:WILLINGBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08046-3907
Mailing Address - Country:US
Mailing Address - Phone:609-871-2454
Mailing Address - Fax:
Practice Address - Street 1:7604 CENTRAL AVE, FRIENDS HALL PHYSICIANS BUILDING,
Practice Address - Street 2:JEANES HOSP.
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19111-2442
Practice Address - Country:US
Practice Address - Phone:215-214-3100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-03
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP007236261QX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0200XAmbulatory Health Care FacilitiesClinic/CenterOncology