Healthcare Provider Details

I. General information

NPI: 1326477951
Provider Name (Legal Business Name): PALMERTON HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2013
Last Update Date: 11/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 LAFAYETTE AVENUE
PALMERTON PA
18071
US

IV. Provider business mailing address

211 NORTH 12TH STREET
LEHIGHTON PA
18235
US

V. Phone/Fax

Practice location:
  • Phone: 610-377-7154
  • Fax: 610-377-7939
Mailing address:
  • Phone: 610-377-7059
  • Fax: 610-377-7618

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number StatePA

VIII. Authorized Official

Name: ANDREA L. ANDRAE
Title or Position: CFO
Credential:
Phone: 610-377-7003