| NPI | 1902858301 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY L MULL System Director Enrollments 570-271-6603 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD044346E) |
| 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine | |
| 291U00000X Clinical Medical Laboratory | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2020-04-20 |