Provider Demographics
NPI:1720593205
Name:ST. CHRISTOPHER'S HEALTHCARE, LLC
Entity Type:Organization
Organization Name:ST. CHRISTOPHER'S HEALTHCARE, LLC
Other - Org Name:ST. CHRISTOPHER'S HOSPITAL FOR CHILDREN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:FREEDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-255-3620
Mailing Address - Street 1:1500 MARKET ST. WEST TOWER
Mailing Address - Street 2:SUITE 2400
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102
Mailing Address - Country:US
Mailing Address - Phone:215-255-3620
Mailing Address - Fax:
Practice Address - Street 1:160 E ERIE AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19134
Practice Address - Country:US
Practice Address - Phone:215-427-5337
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST. CHRISTOPHER'S HEALTHCARE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-12-06
Last Update Date:2018-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment