Provider Demographics
NPI:1215042114
Name:MAIN LINE HOSPITALS, INC.
Entity type:Organization
Organization Name:MAIN LINE HOSPITALS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:LEIGH
Authorized Official - Middle Name:
Authorized Official - Last Name:EHRLICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-337-2029
Mailing Address - Street 1:240 N RADNOR CHESTER RD
Mailing Address - Street 2:
Mailing Address - City:RADNOR
Mailing Address - State:PA
Mailing Address - Zip Code:19087-5170
Mailing Address - Country:US
Mailing Address - Phone:484-337-1814
Mailing Address - Fax:
Practice Address - Street 1:255 W LANCASTER AVE
Practice Address - Street 2:
Practice Address - City:PAOLI
Practice Address - State:PA
Practice Address - Zip Code:19301-1763
Practice Address - Country:US
Practice Address - Phone:610-648-1000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-20
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA161801282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000899205Medicaid
0001107000OtherAMERIHEALTH
NY00739235Medicaid
MD013745600Medicaid
0001107000OtherINDEPENDENCE BLUE CROSS
PA1007354280036Medicaid
0520842OtherCIGNA
GA000162588XMedicaid
00545046-02OtherAMERICHOICE MEDICARE
258208OtherMAMSI/ALLIANCE PPO
PA100727794Medicaid
1024887OtherAETNA HMO & MEDICARE CAP
0001452OtherAETNA
FL912945600Medicaid
CT003035466Medicaid
08310OtherHEALTH PARTNERS
PA60039OtherKEYSTONE MERCY
DC019182700Medicaid
NJ4195400Medicaid