Healthcare Provider Details

I. General information

NPI: 1306175559
Provider Name (Legal Business Name): CHILDREN'S HOSPITAL OF PHILADELPHIA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2009
Last Update Date: 12/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 PULASKI DR
KING OF PRUSSIA PA
19406-2802
US

IV. Provider business mailing address

950 PULASKI DR
KING OF PRUSSIA PA
19406-2802
US

V. Phone/Fax

Practice location:
  • Phone: 610-337-3232
  • Fax: 610-337-0325
Mailing address:
  • Phone: 610-337-3232
  • Fax: 610-337-0325

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL CORBO
Title or Position: CHIEF FINANCE OFFICE
Credential:
Phone: 215-567-2422