1053538470 NPI number — MATERNAL & FAMILY HEALTH SERVICES, INC.

Table of content: (NPI 1053538470)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053538470 NPI number — MATERNAL & FAMILY HEALTH SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MATERNAL & FAMILY HEALTH SERVICES, 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:
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:
1053538470
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/16/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
15 PUBLIC SQ STE 600
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WILKES BARRE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18701-1704
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
570-826-1777
Provider Business Mailing Address Fax Number:
570-823-3450

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2510 W MARKET 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:
17901-1830
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-622-1244
Provider Business Practice Location Address Fax Number:
570-628-2227
Provider Enumeration Date:
04/19/2007

Additional Information

Authorized Official

Authorized Official Last Name:
MANLEY
Authorized Official First Name:
MARGARET
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF FINANCIAL OFFICER
Authorized Official Telephone Number:
570-826-1777

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1039706820007 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0009727330010 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0015798710017 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1007678420033 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0018060110011 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1038879420006 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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