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Organization
TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA
Active
Organization
TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA
Active
Other names
Hospital of the University of Pennsylvania
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS MCCORMICK JR. (AVP OF FINANCE)
(215) 762-0888
Entity
Organization
Contact information
Practice address
3400 SPRUCE ST, PHILADELPHIA, PA 19104-4206
(215) 796-4640
(609) 770-7792
Mailing address
1500 MARKET ST, UM600, PHILADELPHIA, PA 19102-2100
(215) 796-4640
(609) 770-7792
Taxonomy
Speciality
Code
Description
License number
State
273R00000X
Psychiatric Hospital Unit
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001043000
INDEPENDENCE BLUE CROSS
PA
05
—
1001258770126
—
PA
05
—
4193105
—
NJ
Enumeration date
01/27/2006
Last updated
04/07/2023
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