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 East Pavilion, 2Nd Floor, Philadelphia PA 19104-5127. The organization recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology, Allopathic & Osteopathic Physicians / Interventional Cardiology, Allopathic & Osteopathic Physicians / Nuclear Cardiology. Allopathic & Osteopathic Physicians / Cardiovascular Disease is the primary health care specialty. University Of Penn - Medical Group can be contacted via phone (215) 615-4949, or through Jackson, Chante L via phone (215) 662-6187.

Contact Information

Primary practice address
3400 Civic Center Blvd East Pavilion, 2Nd Floor Philadelphia PA 19104-5127
Phone: (215) 615-4949
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Jackson, Chante L
Phone: (215) 662-6187

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X Pennsylvania
Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology 207RC0001X Pennsylvania
Allopathic & Osteopathic Physicians / Interventional Cardiology 207RI0011X Pennsylvania
Allopathic & Osteopathic Physicians / Nuclear Cardiology 207UN0901X

Profile Details

NPI number 1093725145
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 9th, 2006
Last updated Nov 19th, 2020 - about 5 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 1093725145 NPPES
Pennsylvania Other 058354 BLUE SHIELD
Pennsylvania MEDICAID 0006610360 BLUE SHIELD
Pennsylvania Other 10670 BLUE SHIELD
Pennsylvania Other 273543 BLUE SHIELD
Pennsylvania Other CA0235 BLUE SHIELD
Pennsylvania Other 1003417 BLUE SHIELD
Pennsylvania Other 496667 BLUE SHIELD
Pennsylvania Other 0002Y20116 BLUE SHIELD
Pennsylvania Other 027133400001 BLUE SHIELD
Pennsylvania Other 5541301 BLUE SHIELD

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