Organization
TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA
Active
Other names
Penn Home Infusion Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
CASSANDRA I REDMOND (DIRECTOR)
(610) 992-3985
Entity
Organization
Contact information
Practice address
625 CLARK AVE, SUITE 10, KING OF PRUSSIA, PA 19406-1438
(610) 992-3920
(610) 265-7427
Mailing address
625 CLARK AVE, SUITE 10, KING OF PRUSSIA, PA 19406-1438
(610) 992-3920
(610) 265-7427
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
251F00000X
Home Infusion Agency
Primary
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
3336C0003X
Community/Retail Pharmacy
PP414860L
PA
3336H0001X
Home Infusion Therapy Pharmacy
PP414860L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1001258770182
—
PA
05
—
1001258770270
—
PA
Enumeration date
11/21/2005
Last updated
04/07/2023
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