Basic Information
| Provider Information | |||||||||
| NPI: | 1972745941 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | TEMPLE UNIVERSITY HOSPITAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3401 N BROAD ST | ||||||||
| Address2: | 8TH FLOOR ZONE C MEDICINE OFFICE | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191405103 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2157073397 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3401 N BROAD ST | ||||||||
| Address2: | 8TH FLOOR ZONE C MEDICINE OFFICE | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191405103 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2157073397 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/06/2009 | ||||||||
| LastUpdateDate: | 04/06/2009 | ||||||||
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| AuthorizedOfficialLastName: | MOYER | ||||||||
| AuthorizedOfficialFirstName: | DARILYN | ||||||||
| AuthorizedOfficialMiddleName: | V | ||||||||
| AuthorizedOfficialTitleorPosition: | PROGRAM DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 2157074545 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | MT191312 | PA | Y | Hospitals | General Acute Care Hospital |
No ID Information.