Provider Demographics
NPI:1194755892
Name:TENET HEALTH SYSTEM HAHNEMANN, LLC
Entity type:Organization
Organization Name:TENET HEALTH SYSTEM HAHNEMANN, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP OF GOVT PROGRAMS, TENET
Authorized Official - Prefix:MR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:C
Authorized Official - Last Name:ARMIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-775-8040
Mailing Address - Street 1:PO BOX 741230
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-1230
Mailing Address - Country:US
Mailing Address - Phone:215-255-3152
Mailing Address - Fax:215-762-8109
Practice Address - Street 1:BROAD & VINE STREETS
Practice Address - Street 2:MAILSTOP 417
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-1178
Practice Address - Country:US
Practice Address - Phone:215-762-7000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2018-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA081701273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
39-S290Medicare PIN