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General NPI Number Information
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NPI Number | 1023153053
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Entity Type | Organization
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Legal Business Name | THE PENNSYLVANIA HOSPITAL OF THE UNIVERSITY OF PENNSYLVANIA HEALTH SYS
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Dates
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Enumeration Date | 02/20/2007
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Last Update Date | 02/18/2016
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Provider Practice Location Address
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Address Line | 800 SPRUCE ST
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City | PHILADELPHIA
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State | PA
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Zip | 19107-6130
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Country | US
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Telephone | 215-829-5873
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Fax |
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Provider Business Mailing Address
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Address Line | 800 SPRUCE ST
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City | PHILADELPHIA
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State | PA
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Zip | 19107-6130
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Country | US
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Telephone | 215-829-5873
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Fax |
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Authorized Official
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Title or Position | ASSOC VICE PRES FINANCE
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Name | MR. THOMAS M MCCORMICK JR.
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Credential |
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Telephone | 215-796-4640
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | PP415759L
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License Number State | PA
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