| NPI | 1063540011 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY L MULL System Director Credentialing 570-271-6603 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2020-10-05 |