# TPS IV OF PA, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1922201441
- **Authorized official:** DR. PAUL L O'DONNELL D.O. (SURGEON)
- **Authorized official phone:** (215) 762-4315

## Contact information

- **Practice address:** BROAD & VINE STS, PHILADELPHIA, PA 19102
- **Practice address phone:** (215) 762-7000
- **Mailing address:** 245 N 15TH STREET, MS 989, PHILADELPHIA, PA 19102
- **Mailing address phone:** (215) 762-4315
- **Mailing address fax:** (215) 762-4345

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 282N00000X | General Acute Care Hospital | OS010515L | PA | Yes |

## Other

- **Enumeration date:** 06/11/2007
- **Last updated:** 08/22/2020