Organization
MAIN LINE HOSPITALS, INC.
Active
Other names
Bryn Mawr Rehabilitation Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
LEIGH EHRLICH (CHIEF FINANCIAL OFFICER)
(484) 337-2029
Entity
Organization
Contact information
Practice address
414 PAOLI PIKE, MALVERN, PA 19355-3311
(484) 596-5400
Mailing address
240 N RADNOR CHESTER RD, RADNOR, PA 19087-5170
(484) 337-1816
Taxonomy
Speciality
Code
Description
License number
State
283X00000X
Rehabilitation Hospital
Primary
540201
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000066905
—
DE
01
—
0001063000
KEYSTONE 65
PA
01
—
0001063000
AMERIHEALTH
—
01
—
0001121
AETNA
—
01
—
00557261-01
AMERICHOICE-MEDICARE
—
01
—
0078104301
AMERICHOICE HMA
—
05
—
01136121
—
NY
01
—
0524895
CIGNA
PA
01
—
08382
HEALTH PARTNERS
—
05
—
1007354280038
—
PA
05
—
100770006
—
PA
05
—
17000060
—
MD
01
—
258209
MAMSI/ALLIANCE PPO
—
05
—
4205707
—
NJ
01
—
60088
KEYSTONE MERCY
—
01
—
P00838
CHAMPUS TRICARE NORTH REG
—
Enumeration date
08/20/2006
Last updated
09/12/2024
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