1831387208 NPI number — GUTHRIE CLINIC, LTD.

Table of content: (NPI 1831387208)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831387208 NPI number — GUTHRIE CLINIC, LTD.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GUTHRIE CLINIC, LTD.
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:
1831387208
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/10/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 GUTHRIE SQUARE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAYRE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18840-1625
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
570-888-5858
Provider Business Mailing Address Fax Number:
570-882-3007

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 JOHN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TROY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16947-1118
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-297-2121
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/10/2007

Additional Information

Authorized Official

Authorized Official Last Name:
ARMSTRONG
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
C.
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
570-888-5858

Provider Taxonomy Codes

  • Taxonomy code: 207P00000X , 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: GU617122 . This is a "HIGHMARK BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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