THOMAS JEFFERSON UNIVERSITY NPI 1467547968

NPI Information

NPI: 1467547968
Provider Name: THOMAS JEFFERSON UNIVERSITY

Doing Business As: THOMAS JEFFERSON UNIVERSITY DRUG AND ALCOHOL SERVICES

Classification: Public Health or Welfare - 251K00000X
Entity Type: Organization

Address:
1021 SOUTH 21ST STREET
PHILADELPHIA, PA
ZIP 19146
Phone: (215) 735-5979
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THOMAS JEFFERSON UNIVERSITY is a public health or welfare in Philadelphia, PA. THOMAS JEFFERSON UNIVERSITY NPI is 1467547968. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Thomas Jefferson University Drug And Alcohol Services.

The provider's business location address is:

1021 SOUTH 21ST STREET
PHILADELPHIA, PA
ZIP 19146
Phone: (215) 735-5979

The provider's authorized official is Robert Charles Sterling .
The authorized official title is Director and has the following contact phone number (215) 790-9942.

The CLIA number assigned to this NPI record is 39D2290047 - comp. outpatient rehab facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/3/2006 and was last updated on 1/31/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	103TA0400X	Psychologist	Addiction (Substance Use Disorder)			No
2	251K00000X	Public Health or Welfare		820023	PENNSYLVANIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1007571300083	OTHER	PENNSYLVANIA	MEDICAID

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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