Healthcare Provider Details

I. General information

NPI: 1366413106
Provider Name (Legal Business Name): COATESVILLE HOSPITAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2006
Last Update Date: 09/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 REECEVILLE RD
COATESVILLE PA
19320-1542
US

IV. Provider business mailing address

PO BOX 503540
SAINT LOUIS MO
63150-3540
US

V. Phone/Fax

Practice location:
  • Phone: 610-383-8000
  • Fax: 610-383-8360
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number025801
License Number StatePA

VIII. Authorized Official

Name: PAULA M LALOR
Title or Position: DIRECTOR/DELEGATED OFFICIAL
Credential:
Phone: 615-925-4565