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General NPI Number Information
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NPI Number | 1851370910
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Entity Type | Organization
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Legal Business Name | TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA
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Dates
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Enumeration Date | 01/16/2006
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Last Update Date | 12/15/2023
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Provider Practice Location Address
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Address Line | 3400 SPRUCE ST
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City | PHILADELPHIA
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State | PA
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Zip | 19104-4206
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Country | US
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Telephone | 215-796-4640
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Fax | 609-770-7792
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Provider Business Mailing Address
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Address Line | 1500 MARKET ST UPPER MEZZANINE 600
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City | PHILADELPHIA
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State | PA
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Zip | 19102-2100
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Country | US
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Telephone | 215-796-4640
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Fax | 609-770-7792
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Authorized Official
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Title or Position | VICE PRESIDENT FINANCE
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Name | MR. THOMAS M MCCORMICK JR.
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Credential |
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Telephone | 215-762-0888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QA0006X
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Taxonomy Name | Ambulatory Fertility Facility
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License Number |
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 273R00000X
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Taxonomy Name | Psychiatric Hospital Unit
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 276400000X
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Taxonomy Name | Substance Use Disorder Rehabilitation Hospital Unit
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 3416A0800X
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Taxonomy Name | Air Ambulance
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License Number |
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License Number State | PA
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Taxonomy #7
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State |
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