Healthcare Provider Details
I. General information
NPI: 1801831326
Provider Name (Legal Business Name): GEISINGER MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/18/2006
Last Update Date: 05/14/2025
Certification Date: 05/14/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
100 N ACADEMY AVE M.C.15-42
DANVILLE PA
17822-1542
US
IV. Provider business mailing address
100 N ACADEMY AVE
DANVILLE PA
17822-2575
US
V. Phone/Fax
- Phone: 570-271-6451
- Fax: 570-271-7065
- Phone: 570-271-7965
- Fax: 570-271-7370
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0002X |
| Taxonomy | Clinic Pharmacy |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0004X |
| Taxonomy | Compounding Pharmacy |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336I0012X |
| Taxonomy | Institutional Pharmacy |
| License Number | HP418073L |
| License Number State | PA |
VIII. Authorized Official
Name:
CINDY
L
MULL
Title or Position: SYSTEM DIRECTOR CREDENTIALING
Credential:
Phone: 570-271-6603