1164462404 NPI number — GEISINGER COMMUNITY HEALTH SERVICES

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 1164462404 NPI number — GEISINGER COMMUNITY HEALTH SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GEISINGER COMMUNITY HEALTH SERVICES
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:
GEISINGER HOME CARE
Provider Other Organization Name Type Code:
3
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:
1164462404
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 N ACADEMY AVE
Provider Second Line Business Mailing Address:
M.C. 24-11
Provider Business Mailing Address City Name:
DANVILLE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17822-9800
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
570-271-5598
Provider Business Mailing Address Fax Number:
570-271-5597

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
109 WOODBINE LN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DANVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17821-9118
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-271-5598
Provider Business Practice Location Address Fax Number:
570-271-5597
Provider Enumeration Date:
06/07/2006

Additional Information

Authorized Official

Authorized Official Last Name:
LIN
Authorized Official First Name:
DEAN
Authorized Official Middle Name:
Q
Authorized Official Title or Position:
VICE PRESIDENT
Authorized Official Telephone Number:
570-271-8120

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  771805 , 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: 397718 . This is a "BCNEPA PROVIDER #" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 397718 . This is a "CAPTIAL BLUE CROSS PROVID" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 5417705 . This is a "AETNA PROVIDER #" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 136242 . This is a "HEALTH AMERICA PROVIDER #" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1508343 . This is a "GATEWAY HEALTH PLAN PROVI" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 397718 . This is a "BLACK LUNG PROVIDER #" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 397718 . This is a "HEALTHY BEGINNING PLUS PR" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 43018 . This is a "GEISINGER HEALTH PLAN HMO" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 397718 . This is a "AUTO PROVIDER #" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1000038000013 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1820 . This is a "HIGHMARK BS PROVIDER #" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 397718 . This is a "KEYSTONE HEALTH PLAN CENT" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 111008 . This is a "UNISON HEALTH PLAN PROVID" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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