1558693739 NPI number — CARBON-SCHUYLKILL COMMUNITY HOSPITAL, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558693739 NPI number — CARBON-SCHUYLKILL COMMUNITY HOSPITAL, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CARBON-SCHUYLKILL COMMUNITY HOSPITAL, INC.
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:
6
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:
1558693739
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/21/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
02/02/2011
NPI Reactivation Date:
03/21/2011

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
14 N KENNEDY DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MCADOO
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18237-1908
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
570-669-9990
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
14 N KENNEDY DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MCADOO
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18237-1908
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-669-9990
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/12/2010

Additional Information

Authorized Official

Authorized Official Last Name:
BECKER
Authorized Official First Name:
NANCY
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGER, ENROLLMENT CENTER
Authorized Official Telephone Number:
610-954-1881

Provider Taxonomy Codes

  • Taxonomy code: 261QR1300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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