Healthcare Provider Details

I. General information

NPI: 1003979824
Provider Name (Legal Business Name): TEMPLE UNIVERSITY HOSPITAL, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3401 N BROAD ST
PHILA PA
19140-5103
US

IV. Provider business mailing address

3401 N BROAD ST
PHILA PA
19140-5103
US

V. Phone/Fax

Practice location:
  • Phone: 215-707-5303
  • Fax: 215-707-8998
Mailing address:
  • Phone: 215-707-5303
  • Fax: 215-707-8998

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number200701
License Number StatePA

VIII. Authorized Official

Name: MR. ROBERT LUX
Title or Position: CFO AND VP
Credential:
Phone: 215-707-3802