Healthcare Provider Details

I. General information

NPI: 1255829347
Provider Name (Legal Business Name): EVANGELICAL COMMUNITY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2018
Last Update Date: 04/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 MEDICAL PARK DR
LEWISBURG PA
17837-6343
US

IV. Provider business mailing address

1 HOSPITAL DR STE 306
LEWISBURG PA
17837-9350
US

V. Phone/Fax

Practice location:
  • Phone: 570-524-1213
  • Fax: 570-524-0362
Mailing address:
  • Phone: 570-522-4110
  • Fax: 570-768-3911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MICHELE ANN FINK
Title or Position: CREDENTIALING COORDINATOR
Credential:
Phone: 570-522-4110