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) 762-0630
Entity
Organization
Contact information
Practice address
1800 LOMBARD ST, PHILADELPHIA, PA 19146-8400
(215) 893-7246
(215) 893-7246
Mailing address
1500 MARKET ST, UPPER MEZZANINE 600, PHILADELPHIA, PA 19102-2100
(215) 762-0630
(215) 762-0630
Taxonomy
Speciality
Code
Description
License number
State
273Y00000X
Rehabilitation Hospital Unit
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001043000
INDEPENDENCE BLUE CROSS
PA
05
—
1001258770211
—
PA
05
—
4193105
—
NJ
Enumeration date
01/27/2006
Last updated
04/07/2023
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