Basic Information
Provider Information
NPI: 1386896306
EntityType: 2
ReplacementNPI:  
OrganizationName: LANSDALE HOSPITAL CORPORATION
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: LANSDALE HOSPITAL
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 782367
Address2:  
City: PHILADELPHIA
State: PA
PostalCode: 191782367
CountryCode: US
TelephoneNumber: 2153682100
FaxNumber:  
Practice Location
Address1: 100 MEDICAL CAMPUS DR
Address2:  
City: LANSDALE
State: PA
PostalCode: 194461259
CountryCode: US
TelephoneNumber: 2153682100
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/22/2008
LastUpdateDate: 10/03/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: WALSH
AuthorizedOfficialFirstName: MICHAEL
AuthorizedOfficialMiddleName: B
AuthorizedOfficialTitleorPosition: SR. VP OF FINANCE
AuthorizedOfficialTelephone: 2154812851
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/27/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
282N00000X660101PAY HospitalsGeneral Acute Care Hospital 

No ID Information.


Home