=====================================================
General NPI Number Information
=====================================================
NPI Number | 1295902518
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TEMPLE UNIVERSITY HOSPITAL, INC - PSYCH UNIT
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/15/2008
-----------------------------------------------------
Last Update Date | 06/25/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 100 E LEHIGH AVE
-----------------------------------------------------
City | PHILADELPHIA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19125-1012
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-707-3802
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 100 E LEHIGH AVE
-----------------------------------------------------
City | PHILADELPHIA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19125-1012
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CFO & VP OF TUHS
-----------------------------------------------------
Name | MR. ROBERT LUX
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 215-707-3802
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 273R00000X
-----------------------------------------------------
Taxonomy Name | Psychiatric Hospital Unit
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------