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NPI Code Detail

MEDICARE: KENSINGTON HOSPITAL- ERIE MEDICAL CENTER

MEDICARE: KENSINGTON HOSPITAL- ERIE MEDICAL CENTER
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
1261QP2300XPrimary Care Clinic/Center111101PA

General Provider Information

NPI Number : 1710036041
Entity Type Code : Organization
Provider Name (Legal Business Name) : KENSINGTON HOSPITAL- ERIE MEDICAL CENTER
Provider Business Mailing Address
First Line : 516 W ERIE AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19140-4535
Country : US
Telephone Number : 215-228-2844
Fax Number : 215-228-2879
Provider Business Practice Location Address
First Line : 136 DIAMOND ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19122-1721
Country : US
Telephone Number : 215-426-8100
Fax Number : 215-965-2344
Authorized Official
Title or Position : CHIEF EXECUTIVE OFFICER
Name : MS. EILEEN HAUSE
Credential : M.B.A.
Telephone Number : 215-426-8100
Provider Enumeration Date : 01/09/2007
Last Update Date : 05/01/2008

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1922156314 — KENSINGTON HOSPITAL OUTPATIENT TREATMENT PROGRAM
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1144378530 — KENSINGTON HOSPITAL INPATIENT NON-HOSPITAL DETOXIFICATION
Practice Location Address:
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Practice Phone: 215-426-8100
Practice Fax: 215-965-2344

Directions to “KENSINGTON HOSPITAL- ERIE MEDICAL CENTER ” Practice Location

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