| NPI | 1265207187 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY L MULL Director Credentialing & Enrollment 570-271-6603 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 261QA1903X Clinic/Center Ambulatory Surgical |
| 282N00000X General Acute Care Hospital | |
| Enumeration Date | 2023-11-21 |
| Last Update Date | 2025-06-12 |