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General NPI Number Information
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NPI Number | 1700266269
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Entity Type | Organization
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Legal Business Name | 2157627000
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Dates
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Enumeration Date | 05/31/2015
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Last Update Date | 05/31/2015
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Provider Practice Location Address
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Address Line | 2100 W GIRARD AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19130-1400
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Country | US
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Telephone | 215-865-0800
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Fax | 215-685-0846
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Provider Business Mailing Address
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Address Line | 2100 W GIRARD AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19130-1400
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Country | US
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Telephone | 215-865-0800
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Fax | 215-685-0846
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS HAHNEMANN PH
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Name | MISS MARIANNE WARD
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Credential |
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Telephone | 215-762-7000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | MD433799
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License Number State | PA
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