Trustees of the University of Pennsylvania
Organization Active NPI Community/Retail Pharmacy · Philadelphia, PA
NPI 1821760604 · NPPES record last updated Sep 30, 2021
Key facts
- NPI
- 1821760604
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- Legal business name
- TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA
- Practice address
- 1 Convention Ave Ste 1323
Philadelphia, PA 19104-4311 - Phone
- (267) 862-1600
- NPI assigned
- Sep 30, 2021
- Organization subpart
- No
Authorized official
- Name
- Genevieve Levans
- Title
- Associate Director
- Phone
- (215) 796-2085
Owned or controlled facilities with NPI records 20
Other NPIs on the same Medicare enrollment 3
Other NPIs with the same Medicare PAC ID 11
Corporate family (same tax ID) 43
Practitioners 152
-
Riley Elizabeth Ambrose, CRNP
-
Gabrielle Arndt, CRNP
-
Ayisha Arshad, FNP-BC
-
Soussan Ayubcha, MD
-
Salina Bakshi, M.D.
-
Marguerite Balasta, M.D.
-
Aaron S Best, DO
-
Renee Marie Betancourt, M.D.
-
Cheryl Ann Bettigole, M.D.
-
Amber-Nicole Bird, M.D.
-
Patricia M Bomalaski, CRNP
-
Karen E Bowles, MD
-
William M Brady, MD
-
Kent D Bream, MD
-
Robin E Canada, MD
-
Judy S Chertok, MD
Laboratory certificates & supplier records
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Trustees of the University of PA |
Epoetin|Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs | Accepts assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in PA
All facility ownership & control disclosures 17
| Facility | Type | Role | Since |
|---|---|---|---|
| Penn Medicine Princeton Medical Center |
Hospital | 5% Or Greater Indirect Ownership Interest (100%) | Jan 1, 2018 |
| Lancaster General Hospital |
Hospital | 5% Or Greater Indirect Ownership Interest | Aug 1, 2015 |
| Hospital of the University of Pennsylvania |
Hospital | 5% Or Greater Direct Ownership Interest Operational/Managerial Control |
Oct 18, 2007 Oct 18, 2007 |
| Hospital of the University of Pennsylvania |
Hospital | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
Nov 16, 2007 Nov 16, 2017 |
| The Pennsylvania Hospital of the University of Pennsylvania Health Sys |
Hospital | 5% Or Greater Direct Ownership Interest (100%) | Apr 30, 1997 |
| The Pennsylvania Hospital of the University of Pennsylvania Health Sys |
Hospital | 5% Or Greater Direct Ownership Interest | Apr 30, 1997 |
| Penn Presbyterian Medical Center |
Hospital | 5% Or Greater Direct Ownership Interest (100%) | Jun 13, 1995 |
| Penn Medicine | Good Shepherd Rehabilitation |
Hospital | Other (49%) | Jul 1, 2019 |
| Chester County Hospital |
Hospital | 5% Or Greater Indirect Ownership Interest (100%) | Sep 1, 2013 |
| Penn Medicine Princeton Medical Center Acute Rehabilitation Center |
Hospital | 5% Or Greater Indirect Ownership Interest (100%) | Jan 1, 2018 |
| Penn Medicine Princeton House Behavioral Health |
Hospital | 5% Or Greater Indirect Ownership Interest (100%) | Jan 1, 2018 |
| Lancaster Behavioral Health Hospital |
Hospital | 5% Or Greater Indirect Ownership Interest (100%) | Apr 7, 2014 |
| Rittenhouse Post Acute |
Skilled nursing facility | Adp of the SNF | Sep 12, 2024 |
| Penn Medicine Home Health |
Home health agency | 5% Or Greater Direct Ownership Interest (100%) | Jun 13, 1995 |
| Penn Medicine Home Health Princeton Health |
Home health agency | 5% Or Greater Indirect Ownership Interest (100%) | Jan 1, 2018 |
| Penn Medicine Hospice Princeton Health |
Hospice | 5% Or Greater Indirect Ownership Interest (100%) | Jan 1, 2018 |
| Penn Medicine Hospice |
Hospice | 5% Or Greater Direct Ownership Interest (100%) | Apr 1, 1997 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20151105002164 | PA | Part B Supplier - Mass Immunization (Roster Biller Only) | 2062326507 |
3 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Philadelphia, PA; Radnor, PA |
| O20230207000117 | PA | DME Supplier - Pharmacy | 2062326507 | Practice locations: Philadelphia, PA |
National Provider Directory
- Tax ID family
- Univ of Penn Dept of NE
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | Yes |
Addresses
Primary practice location
1 Convention Ave Ste 1323
Philadelphia, PA 19104-4311
Mailing address
3400 Spruce St
Ground Rhodes
Philadelphia, PA 19104
Other names
- Penn Pavilion Pharmacy
Other providers in Philadelphia, PA
- Trustees of the University of Pennsylvania
- Trustees of the University of Pennsylvania
- Trustees of the University of Pennsylvania
- Trustees of the University of Pennsylvania
- Trustees of the University of Pennsylvania
- Trustees of the University of Pennsylvania
- Trustees of the University of Pennsylvania
- Trustees of the University of Pennsylvania
- Trustees of the University of Pennsylvania
- Trustees of the University of Pennsylvania
All providers in Philadelphia, PA · Community/Retail Pharmacy in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 30, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.