MEDICARE: JEANES HOSPITAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	282N00000X	General Acute Care Hospital	101301	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	0001015000	OTHER	PA	BLUE CROSS PROVIDER #
3	1468	OTHER	PA	AETNA HMO

General Provider Information

NPI Number	:	1912902206
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JEANES HOSPITAL

Provider Business Mailing Address
First Line	:	7600 CENTRAL AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19111-2442
Country	:	US
Telephone Number	:	215-728-3306
Fax Number	:	215-728-3322

Provider Business Practice Location Address
First Line	:	7600 CENTRAL AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19111-2442
Country	:	US
Telephone Number	:	215-728-3306
Fax Number	:	215-728-3322

Authorized Official
Title or Position	:	CFO
Name	:	MR. RAY LEFTON
Credential	:
Telephone Number	:	215-728-3306

Provider Enumeration Date	:	06/15/2005
Last Update Date	:	09/15/2015

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Directions to “JEANES HOSPITAL ” Practice Location

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