1265438246 NPI number — CENTRAL PA HEMATOLOGY & MEDICAL ONCOLOGY ASSOCIATES, PC

Table of content: DR. SEABORN BECK WEATHERS MD (NPI 1568493872)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265438246 NPI number — CENTRAL PA HEMATOLOGY & MEDICAL ONCOLOGY ASSOCIATES, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CENTRAL PA HEMATOLOGY & MEDICAL ONCOLOGY ASSOCIATES, PC
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:
Provider Other Organization Name Type Code:
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:
1265438246
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/24/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
50 N 12TH ST
Provider Second Line Business Mailing Address:
UPPR LEVEL
Provider Business Mailing Address City Name:
LEMOYNE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17043-1428
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-737-5767
Provider Business Mailing Address Fax Number:
717-737-6268

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
50 N 12TH ST
Provider Second Line Business Practice Location Address:
UPPR LEVEL
Provider Business Practice Location Address City Name:
LEMOYNE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17043-1428
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-737-5767
Provider Business Practice Location Address Fax Number:
717-737-6268
Provider Enumeration Date:
06/23/2005

Additional Information

Authorized Official

Authorized Official Last Name:
MCCORKLE
Authorized Official First Name:
JOYCE
Authorized Official Middle Name:
ANN
Authorized Official Title or Position:
PRACTICE MANAGER
Authorized Official Telephone Number:
717-737-5767

Provider Taxonomy Codes

  • Taxonomy code: 291U00000X , 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: 022719 . This is a "LAB IDENTIFICATION NUMBER" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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