Healthcare Provider Details
I. General information
NPI: 1093555120
Provider Name (Legal Business Name): GEISINGER MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/28/2024
Last Update Date: 05/28/2024
Certification Date: 05/21/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
35 JUSTIN DRIVE
DANVILLE PA
17821
US
IV. Provider business mailing address
100 N ACADEMY AVE
DANVILLE PA
17822-4903
US
V. Phone/Fax
- Phone: 570-271-6028
- Fax: 570-271-5845
- Phone: 570-271-6144
- Fax: 570-271-6578
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CINDY
L
MULL
Title or Position: SYSTEM DIRECTOR CREDENTIALING
Credential:
Phone: 570-271-6603