Provider Demographics
NPI:1295278786
Name:TEMPLE UNIVERSITY HOSPITAL, INC
Entity type:Organization
Organization Name:TEMPLE UNIVERSITY HOSPITAL, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:BARCELLONA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-707-3802
Mailing Address - Street 1:333 COTTMAN AVENUE
Mailing Address - Street 2:P1001
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19111
Mailing Address - Country:US
Mailing Address - Phone:215-214-4203
Mailing Address - Fax:215-214-4206
Practice Address - Street 1:333 COTTMAN AVENUE
Practice Address - Street 2:P1001
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19111
Practice Address - Country:US
Practice Address - Phone:215-214-4203
Practice Address - Fax:215-214-4206
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TEMPLE UNIVERSITY HOSPITAL, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-12-01
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336S0011X, 333600000X
PAPP4826933336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100773699Medicaid
2166402OtherPK