Provider Demographics
NPI:1891010229
Name:ALBERT EINSTEIN MEDICAL CENTER
Entity Type:Organization
Organization Name:ALBERT EINSTEIN MEDICAL CENTER
Other - Org Name:EINSTEIN AT CENTER ONE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:NETWORK DIRECTOR OF PHARMACY
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:GAIL
Authorized Official - Last Name:HAUSER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:215-456-6486
Mailing Address - Street 1:9880 BUSTLETON AVE STE 305
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19115-2144
Mailing Address - Country:US
Mailing Address - Phone:215-827-1680
Mailing Address - Fax:215-827-1389
Practice Address - Street 1:9880 BUSTLETON AVE STE 305
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19115-2144
Practice Address - Country:US
Practice Address - Phone:215-827-1680
Practice Address - Fax:215-827-1389
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALBERT EINSTEIN HEALTHCARE NETWORK
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-03-29
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP481810333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007544140133Medicaid
PA6495110002Medicare NSC