MEDICARE: CHILDRENS HOSPITAL OF PHILADELPHIA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	261Q00000X	Clinic/Center
2	261QE0700X	End-Stage Renal Disease (ESRD) Treatment Clinic/Center
3	282N00000X	General Acute Care Hospital
4	283XC2000X	Children's Rehabilitation Hospital
5	282NC2000X	Children's Hospital

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	P000851	OTHER	PA	CHAMPUS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	0001006000	OTHER	PA	IBC
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	393303	OTHER	PA	HORIZON BLUE CROSS
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11	505533072	OTHER	PA	CIGNA
12	0001426	OTHER	PA	AETNA/US HEALTHCARE
13	393303	OTHER	PA	KEYSTONE HEALTH PLAN EAST

General Provider Information

NPI Number	:	1215921457
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHILDRENS HOSPITAL OF PHILADELPHIA

Provider Business Mailing Address
First Line	:	3401 CIVIC CENTER BLVD
Second Line	:	PARC BUSINESS SVCS
City	:	PHILADELPHIA
State	:	PA
Zip	:	19104-4319
Country	:	US
Telephone Number	:	267-426-5722
Fax Number	:	267-426-7138

Provider Business Practice Location Address
First Line	:	34TH AND CIVIC CENTER BLVD
Second Line	:	PARC BUSINESS SVCS
City	:	PHILADELPHIA
State	:	PA
Zip	:	19104-4306
Country	:	US
Telephone Number	:	267-426-5722
Fax Number	:	267-426-7138

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MS. DIERDRA YOUNG
Credential	:
Telephone Number	:	267-426-5722

Provider Enumeration Date	:	09/02/2005
Last Update Date	:	06/13/2023

Similar Medicare Providers

1790907673 — DR. KEVIN DUFFY JR. MD
Practice Location Address:

3400 CIVIC CENTER BLVD , EAST PAVILION, 2ND FLOOR
PHILADELPHIA, PA
19104-4306

Practice Phone: 215-615-4949
Practice Fax: 215-615-0829

1992936306 — TAISEI JOHN KOBAYASHI MD
Practice Location Address:

3400 CIVIC CENTER BLVD , EAST PAVILION, 2ND FLOOR
PHILADELPHIA, PA
19104-4306

Practice Phone: 215-615-4949
Practice Fax: 215-615-0829

1124027727 — JOEL D GLICKMAN MD
Practice Location Address:

3400 CIVIC CENTER BLVD , 1ST FLOOR, SUITE 300 S
PHILADELPHIA, PA
19104-4306

Practice Phone: 215-662-2638
Practice Fax: 215-349-5703

1164424776 — DENNIS L. SPRECHER M.D.
Practice Location Address:

3400 CIVIC CENTER BOULEVARD , EAST PAVILION, 2ND FLOOR
PHILADELPHIA, PA
19104-4306

Practice Phone: 215-615-4949
Practice Fax: 215-615-0829

1417944844 — MS. LINDA MARGUERITA MILLER RN CRNP
Practice Location Address:

3400 CIVIC CENTER BLVD , ENT DEPT FIRST FLOOR WOOD BLDG
PHILADELPHIA, PA
19104-4306

Practice Phone: 215-590-3440
Practice Fax: 215-590-3986

1154318160 — MS. TERESA GIORDANO CRNP
Practice Location Address:

3400 CIVIC CENTER BLVD , 1ST FLOOR WOOD BLDG DEPARTMENT OF OTOLARYNGOLOGY
PHILADELPHIA, PA
19104-4306

Practice Phone: 215-590-3440
Practice Fax: 215-590-3986

Directions to “CHILDRENS HOSPITAL OF PHILADELPHIA ” Practice Location

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