Healthcare Provider Details

I. General information

NPI: 1578582516
Provider Name (Legal Business Name): COLUMBIA MONTOUR FAMILY HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 5TH STREET HOLLOW ROAD SUITE 1
BLOOMSBURG PA
17815
US

IV. Provider business mailing address

2201 5TH STREET HOLLOW RAOD SUITE 1
BLOOMSBURG PA
17815
US

V. Phone/Fax

Practice location:
  • Phone: 570-387-0236
  • Fax: 570-784-1942
Mailing address:
  • Phone: 570-387-0236
  • Fax: 570-784-1942

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QA0005X
TaxonomyAmbulatory Family Planning Facility
License Number
License Number State

VIII. Authorized Official

Name: MRS. SWANEE BARBARA MARCUS
Title or Position: EXECUTIVE DIRECTOR
Credential: CRNP
Phone: 570-387-0236