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General NPI Number Information
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NPI Number | 1093255812
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Entity Type | Organization
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Legal Business Name | PENNSYLVANIA HOSPITAL
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Dates
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Enumeration Date | 02/27/2017
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Last Update Date | 02/27/2017
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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 | 215-829-5451
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Fax |
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Provider Business Mailing Address
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Address Line | 1211 EVERGREEN RD
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City | RIEGELSVILLE
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State | PA
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Zip | 18077-7024
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Country | US
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Telephone | 215-688-0099
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Fax |
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Authorized Official
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Title or Position | CLINICAL PHARMACIST
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Name | JOSEPH P REO
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Credential | RPH
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Telephone | 215-829-5451
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | RP034029R
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License Number State | PA
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