University Of Penn-Medical Group

LBN: University Of Penn-Medical Group
University Of Penn-Medical Group is an health care organization with primary practice located at 3400 Civic Center Blvd 1St Floor, Philadelphia PA 19104-5127. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Rheumatology. Allopathic & Osteopathic Physicians / Rheumatology is the primary health care specialty. University Of Penn-Medical Group can be contacted via phone (215) 662-2454, or through Jackson, Chante L via phone (215) 662-6187.

Contact Information

Primary practice address
3400 Civic Center Blvd 1St Floor Philadelphia PA 19104-5127
Phone: (215) 662-2454
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Jackson, Chante L
Phone: (215) 662-6187

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X Pennsylvania
Allopathic & Osteopathic Physicians / Rheumatology 207RR0500X Pennsylvania

Profile Details

NPI number 1982717641
LBN Legal business name University Of Penn-Medical Group
DBA Doing business as
Authorized official Jackson, Chante L
Entity Organization
Organization subpart 1 No
Enumeration date Aug 16th, 2006
Last updated Nov 20th, 2020 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1982717641 NPPES
Pennsylvania Other 0276505000 KEYSTONE
Pennsylvania Other CA0235 KEYSTONE
Pennsylvania Other 5443300 KEYSTONE
Pennsylvania Other 496695 KEYSTONE
Pennsylvania Other 140756 KEYSTONE
Pennsylvania MEDICAID 0006610360 KEYSTONE
Pennsylvania Other 1010975 KEYSTONE
Pennsylvania Other 0002Y20116 KEYSTONE
Pennsylvania Other 273257 KEYSTONE
Pennsylvania Other 020255499 KEYSTONE
Pennsylvania Other 31848 KEYSTONE
Pennsylvania Other G00048560 KEYSTONE

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