| NPI | 1669709085 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH F CAMPANA Doctor/Pres 570-323-7187 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: PA 207Y00000X) |
| Additional Taxonomies | 302F00000X Exclusive Provider Organization (Licence: PA 207W00000X) |
| Enumeration Date | 2009-11-05 |
| Last Update Date | 2009-11-17 |