Provider Demographics
NPI:1023267861
Name:PA HOSPITAL OF THE UNIVERSITY OF PA HEALTH SYSTEM
Entity type:Organization
Organization Name:PA HOSPITAL OF THE UNIVERSITY OF PA HEALTH SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:ROSE
Authorized Official - Middle Name:
Authorized Official - Last Name:FRITTICCI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-829-5268
Mailing Address - Street 1:800 SPRUCE ST
Mailing Address - Street 2:HALL MERCER CMH/MRC
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-6130
Mailing Address - Country:US
Mailing Address - Phone:215-829-5268
Mailing Address - Fax:215-829-8771
Practice Address - Street 1:800 SPRUCE ST
Practice Address - Street 2:HALL MERCER CMH/MRC
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-6130
Practice Address - Country:US
Practice Address - Phone:215-829-5268
Practice Address - Fax:215-829-8771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-17
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit