1518966753 NPI number — LEHIGH VALLEY HOSPITAL SCHUYLKILL

Table of content: (NPI 1518966753)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518966753 NPI number — LEHIGH VALLEY HOSPITAL SCHUYLKILL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LEHIGH VALLEY HOSPITAL SCHUYLKILL
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:
THE POTTSVILLE HOSPITAL AND WARNE CLINIC REHABILITATION UNIT
Provider Other Organization Name Type Code:
4
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:
1518966753
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/18/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 4120
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ALLENTOWN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18105-4120
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
484-884-3219
Provider Business Mailing Address Fax Number:
484-884-3392

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
420 S JACKSON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
POTTSVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17901-3625
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-621-5000
Provider Business Practice Location Address Fax Number:
570-622-8221
Provider Enumeration Date:
07/19/2005

Additional Information

Authorized Official

Authorized Official Last Name:
MARCHOZZI
Authorized Official First Name:
THOMAS
Authorized Official Middle Name:
Authorized Official Title or Position:
SR VP & CFO
Authorized Official Telephone Number:
484-862-3943

Provider Taxonomy Codes

  • Taxonomy code: 273Y00000X , with the licence number:  421001 , 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: 39-T030 . This is a "CAPITAL BLUE CROSS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 100760725-0022 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1500 . This is a "HIGHMARK/BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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