Main Line Hospitals, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

120402 Issued in PA

Legal business name

MAIN LINE HOSPITALS, INC.

Practice address

100 E Lancaster Ave
Wynnewood, PA 19096-3450

Phone

(610) 645-6400

Fax

(610) 645-3399

NPI assigned

Sep 26, 2005

Last updated

Oct 19, 2007By the provider in NPPES

Organization subpart

Yes

Parent organization

MAIN LINE HOSPITALS, INC.As reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Charles J. Rogers, NHA

Title

Administrator

Phone

(610) 645-6400

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Lankenau Hospital Transitional Care Center Other name

Part of

Bryn Mawr Hosp Dept of

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Prem K Kittusamy, MD

  • Cardiovascular Disease Physician
  • Las Vegas, NV
  • NPI 1568478840
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1127692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192752000000",
    "number": "1275529190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E LANCASTER AVE",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963450",
            "telephone_number": "610-645-6400",
            "fax_number": "610-645-3399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E LANCASTER AVE",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963450",
            "telephone_number": "610-645-6400",
            "fax_number": "610-645-3399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN LINE HOSPITALS, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MAIN LINE HOSPITALS, INC.",
        "enumeration_date": "2005-09-26",
        "last_updated": "2007-10-19",
        "status": "A",
        "authorized_official_last_name": "ROGERS",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "610-645-6400",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "NHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "PA",
            "license": "120402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "1427",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENCE BLUE CROSS P",
            "identifier": "1730",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE HEALTH PLAN HMO",
            "identifier": "001730",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lankenau Hospital Transitional Care Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Skilled Nursing Facility in Wynnewood, PA
• Providers in Wynnewood, PA by specialty
• Skilled Nursing Facility in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.