Provider Demographics
NPI:1396850368
Name:MAIN LINE HOSPITALS, INC.
Entity type:Organization
Organization Name:MAIN LINE HOSPITALS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:LEIGH
Authorized Official - Middle Name:
Authorized Official - Last Name:EHRLICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-337-2029
Mailing Address - Street 1:240 N RADNOR CHESTER RD
Mailing Address - Street 2:
Mailing Address - City:RADNOR
Mailing Address - State:PA
Mailing Address - Zip Code:19087-5170
Mailing Address - Country:US
Mailing Address - Phone:484-337-1816
Mailing Address - Fax:
Practice Address - Street 1:414 PAOLI PIKE
Practice Address - Street 2:
Practice Address - City:MALVERN
Practice Address - State:PA
Practice Address - Zip Code:19355-3311
Practice Address - Country:US
Practice Address - Phone:484-596-5400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-20
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA540201283X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283X00000XHospitalsRehabilitation Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100770006Medicaid
NJ4205707Medicaid
P00838OtherCHAMPUS TRICARE NORTH REG
0001121OtherAETNA
PA0524895OtherCIGNA
NY01136121Medicaid
258209OtherMAMSI/ALLIANCE PPO
DE000066905Medicaid
08382OtherHEALTH PARTNERS
PA1007354280038Medicaid
0001063000OtherAMERIHEALTH
00557261-01OtherAMERICHOICE-MEDICARE
0078104301OtherAMERICHOICE HMA
MD17000060Medicaid
PA0001063000OtherKEYSTONE 65
PA0001063000OtherINDEPENDENCE BLUE CROSS
60088OtherKEYSTONE MERCY
PA100770006Medicaid