1528061314 NPI number — SHAMOKIN AREA COMMUNITY HOSPITAL

Table of content: (NPI 1528061314)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528061314 NPI number — SHAMOKIN AREA COMMUNITY HOSPITAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SHAMOKIN AREA COMMUNITY HOSPITAL
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:
1528061314
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/22/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4200 HOSPITAL RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COAL TOWNSHIP
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17866-9668
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
570-644-4200
Provider Business Mailing Address Fax Number:
570-644-4351

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4200 HOSPITAL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COAL TOWNSHIP
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17866-9668
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-644-4200
Provider Business Practice Location Address Fax Number:
570-644-4351
Provider Enumeration Date:
05/24/2005

Additional Information

Authorized Official

Authorized Official Last Name:
MORRIS
Authorized Official First Name:
RANDY
Authorized Official Middle Name:
Authorized Official Title or Position:
V.P., CFO
Authorized Official Telephone Number:
570-644-4229

Provider Taxonomy Codes

  • Taxonomy code: 282NR1301X , with the licence number:  196501 , 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: 1007753070010 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1516 . This is a "HIGHMARK ACUTE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 66283 . This is a "MEDPLUS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 74340 . This is a "MEDPLUS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1007753070003 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1012710001 . This is a "HEALTH AMERICA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1501462 . This is a "GATEWAY" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1007753070009 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 25714 . This is a "GEISINGER HEALTH PLAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 56136 . This is a "MEDPLUS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1007753070004 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 030086400 . This is a "FEDERAL BLACK LUNG PROGRA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 56137 . This is a "MEDPLUS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com