Healthcare Provider Details

I. General information

NPI: 1194725861
Provider Name (Legal Business Name): MERCY HOSPITAL OF NANTICOKE PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

128 W WASHINGTON ST
NANTICOKE PA
18634-3113
US

IV. Provider business mailing address

PO BOX 2040
SCRANTON PA
18501-2040
US

V. Phone/Fax

Practice location:
  • Phone: 570-348-7055
  • Fax:
Mailing address:
  • Phone: 570-348-7055
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282E00000X
TaxonomyLong Term Care Hospital
License Number141401
License Number StatePA

VIII. Authorized Official

Name: MR. STEVE H FRANKO III
Title or Position: CFO
Credential:
Phone: 570-348-7074