Provider Demographics
NPI:1902261324
Name:CHILDRENS HOSPITAL OF PHILADELPHIA
Entity Type:Organization
Organization Name:CHILDRENS HOSPITAL OF PHILADELPHIA
Other - Org Name:CHOP INTEGRATIVE HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP REV CYCLE & REIM STRATEGY
Authorized Official - Prefix:
Authorized Official - First Name:ED
Authorized Official - Middle Name:
Authorized Official - Last Name:BLEACHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-426-6179
Mailing Address - Street 1:3401 CIVIC CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-4319
Mailing Address - Country:US
Mailing Address - Phone:215-590-5043
Mailing Address - Fax:267-426-2455
Practice Address - Street 1:3500 CIVIC CENTER BLVD FL 12
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4395
Practice Address - Country:US
Practice Address - Phone:215-590-5043
Practice Address - Fax:267-426-2455
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHILDRENS HOSPITAL OF PHILADELPHIA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-12-30
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No207LP3000XAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric AnesthesiologyGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty