1316919699 NPI number — BERWICK HOSPITAL COMPANY LLC

Table of content: (NPI 1316919699)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316919699 NPI number — BERWICK HOSPITAL COMPANY LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BERWICK HOSPITAL COMPANY LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
BERWICK HOSPITAL CENTER
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1316919699
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/25/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
701 E 16TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BERWICK
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18603-2316
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
570-759-5000
Provider Business Mailing Address Fax Number:
570-759-3473

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
701 E 16TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BERWICK
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18603-2316
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-759-5000
Provider Business Practice Location Address Fax Number:
570-759-3473
Provider Enumeration Date:
02/02/2006

Additional Information

Authorized Official

Authorized Official Last Name:
LALOR
Authorized Official First Name:
PAULA
Authorized Official Middle Name:
M
Authorized Official Title or Position:
DIRECTOR/DELEGATED OFFICIAL
Authorized Official Telephone Number:
615-925-4565

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  024901 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 009605 . This is a "FIRST PRIORITY HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 390072 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0009605 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1583 . This is a "HIGHMARK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 20352 . This is a "GHP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1007562590006 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 039666600 . This is a "BLACK LUNG" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1007562590003 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1503308 . This is a "GATEWAY" identifier . This identifiers is of the category "OTHER".




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