Healthcare Provider Details

I. General information

NPI: 1366448268
Provider Name (Legal Business Name): COLUMBIA MONTOUR HOME HEALTH SERVICES VNA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2005
Last Update Date: 07/24/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 GLENN AVE SUITE 200
BLOOMSBURG PA
17815-1200
US

IV. Provider business mailing address

410 GLENN AVE SUITE 200
BLOOMSBURG PA
17815-1200
US

V. Phone/Fax

Practice location:
  • Phone: 570-784-1723
  • Fax: 570-784-8512
Mailing address:
  • Phone: 570-784-1723
  • Fax: 570-784-8512

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number708605
License Number StatePA

VIII. Authorized Official

Name: MRS. JANE GITTLER
Title or Position: CEO
Credential: RN
Phone: 570-784-1723