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Organization

CHILDRENS HOSPITAL OF PHILADELPHIA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. DIERDRA YOUNG (DIRECTOR)
(267) 426-5722
Entity
Organization

Contact information

Practice address
34TH AND CIVIC CENTER BLVD, PARC BUSINESS SVCS, PHILADELPHIA, PA 19104-4306
(267) 426-5722
(267) 426-7138
Mailing address
3401 CIVIC CENTER BLVD, PARC BUSINESS SVCS, PHILADELPHIA, PA 19104-4319
(267) 426-5722
(267) 426-7138

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
282N00000X
General Acute Care Hospital
282NC2000X
Children's Hospital
Primary
283XC2000X
Children's Rehabilitation Hospital

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0001006000
IBC
PA
01
0001426
AETNA/US HEALTHCARE
PA
05
0052815201
PA
05
0052815202
PA
05
01000275400
PA
05
1007709910056
PA
05
1007709910059
PA
05
1007709910078
PA
01
393303
HORIZON BLUE CROSS
PA
05
4204301
PA
01
505533072
CIGNA
PA
01
P000851
CHAMPUS
PA
Enumeration date
09/02/2005
Last updated
06/13/2023
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