| NPI | 1013969443 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY L MULL System Director Enrollment 570-271-6603 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207ZP0105X Pathology Clinical Pathology/Laboratory Medicine |
| 291U00000X Clinical Medical Laboratory | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2020-04-09 |