MEDICARE: TEMPLE UNIVERSITY HOSPITAL

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	281P00000X	Chronic Disease Hospital	197026	PA

General Provider Information

NPI Number	:	1689049348
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TEMPLE UNIVERSITY HOSPITAL

Provider Business Mailing Address
First Line	:	3400 N BROAD ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19140-5104
Country	:	US
Telephone Number	:	215-707-3397
Fax Number	:

Provider Business Practice Location Address
First Line	:	3400 N BROAD ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19140-5104
Country	:	US
Telephone Number	:	215-707-5978
Fax Number	:

Authorized Official
Title or Position	:	PROGRAM COORDINATOR
Name	:	MS. ALICE WENT
Credential	:
Telephone Number	:	215-707-5978

Provider Enumeration Date	:	12/07/2015
Last Update Date	:	12/07/2015

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Directions to “TEMPLE UNIVERSITY HOSPITAL ” Practice Location

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