Organization
GOOD SHEPHERD PENN PARTNERS PENN SPECIALTY HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RONALD PETULA (SVP FINANCE AND CFO)
(610) 776-3228
Entity
Organization
Contact information
Practice address
20 E 11TH AVE, CONSHOHOCKEN, PA 19428-1555
(610) 828-7505
Mailing address
1800 LOMBARD ST, PHILADELPHIA, PA 19146-1414
(877) 969-7342
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
22460101
PA
Other
Enumeration date
10/17/2016
Last updated
10/17/2016
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