| Hospital Of The University Of Pennsylvania | |
|
3400 Spruce St Philadelphia PA 19104-4206 | |
| (215) 796-4640 | |
| (609) 770-7792 |
| Full Name | Hospital Of The University Of Pennsylvania |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 3400 Spruce St, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Thomas Mccormick (AVP OF FINANCE) |
| Authorized Official Contact | 2157620888 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hospital Of The University Of Pennsylvania 1500 Market St Um600 Philadelphia PA 19102-2100 Ph: (215) 796-4640 | Hospital Of The University Of Pennsylvania 3400 Spruce St Philadelphia PA 19104-4206 Ph: (215) 796-4640 |
| NPI Number | 1679544803 |
|---|---|
| Provider Enumeration Date | 01/27/2006 |
| Last Update Date | 04/07/2023 |
| Certification Date | 04/07/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679544803 | NPI | - | NPPES |
| 0001043000 | Other | PA | INDEPENDENCE BLUE CROSS |
| 4193105 | Medicaid | NJ | |
| 1001258770126 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | (* (Not Available)) | Primary |
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