Provider Demographics
NPI:1215916002
Name:THOMAS JEFFERSON UNIVERSITY HOSPITALS INC
Entity type:Organization
Organization Name:THOMAS JEFFERSON UNIVERSITY HOSPITALS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR VICE PRESIDENT FOR FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:
Authorized Official - Last Name:LUBARSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-955-9895
Mailing Address - Street 1:P.O.BOX 85009895
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-0001
Mailing Address - Country:US
Mailing Address - Phone:215-955-7106
Mailing Address - Fax:215-955-8732
Practice Address - Street 1:111 S 11TH ST
Practice Address - Street 2:2210 GIBBON BUILDING
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-4824
Practice Address - Country:US
Practice Address - Phone:215-955-7106
Practice Address - Fax:215-955-8732
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-11
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA200801282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0001078000OtherBLUE CROSS
PA100757130051Medicaid
PA100757130070Medicaid
PA60005OtherKMHP
PA0005619000OtherBLUE CROSS
PA0053721307OtherAMERICHOICE OUTPATIENT
PA0001016000OtherBLUE CROSS
PA0001480OtherAETNA PPO
PA52192OtherELDERHEALTH
PA0001016000OtherAMERIHEALTH
PA0001480OtherAETNA US HEALTHCARE
PA100757130057Medicaid
PA100757130094Medicaid
PA120735OtherAETNA US HEALTHCARE SNF
PA0001016000OtherBLUE CROSS
PA100757130070Medicaid
PA100757130094Medicaid
PA120735OtherAETNA US HEALTHCARE SNF