Healthcare Provider Details

I. General information

NPI: 1659469328
Provider Name (Legal Business Name): SCCI HOSPITAL EASTON, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 11/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 S 21ST ST
EASTON PA
18042-3851
US

IV. Provider business mailing address

680 S 4TH ST K-LIVE 5 REIMBURSEMENT
LOUISVILLE KY
40202-2407
US

V. Phone/Fax

Practice location:
  • Phone: 610-250-4724
  • Fax:
Mailing address:
  • Phone: 502-596-7300
  • Fax: 502-596-4134

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282E00000X
TaxonomyLong Term Care Hospital
License Number31040100
License Number StatePA

VIII. Authorized Official

Name: MR. ARTHUR L. ROTHGERBER
Title or Position: SR. VP OF REIMBURSEMENT
Credential:
Phone: 502-596-7300