Organization
METHODIST HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NEIL LUBARSKY (SENIOR VICE PRESIDENT)
(215) 955-9895
Entity
Organization
Contact information
Practice address
2301 SOUTH BROAD, BROAD AND WOLF STREETS, PHILADELPHIA, PA 19145
(215) 955-7106
(215) 955-8732
Mailing address
PO BOX 85009895, PHILADELPHIA, PA 19178-0001
(215) 955-7106
(215) 955-8732
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
200801
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001021000
BLUE CROSS
PA
01
—
0001461
AETNA
PA
05
—
1007571300061
—
PA
01
—
390174
CBH
PA
01
—
6490945
AETNA PPO
PA
Enumeration date
12/04/2006
Last updated
08/22/2020
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