1396402053 NPI number — LEHIGH VALLEY HOSPITAL- POCONO

Table of content: (NPI 1396402053)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396402053 NPI number — LEHIGH VALLEY HOSPITAL- POCONO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LEHIGH VALLEY HOSPITAL- POCONO
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:
1396402053
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/09/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2100 MACK BLVD
Provider Second Line Business Mailing Address:
PO BOX 4000
Provider Business Mailing Address City Name:
ALLENTOWN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18105-4000
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
484-884-3025
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
330 MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DICKSON CITY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18519-1691
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
484-884-3025
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/17/2021

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MARCHOZZI
Authorized Official First Name:
THOMAS
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE VP & CFO
Authorized Official Telephone Number:
484-862-3943

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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