Healthcare Provider Details

I. General information

NPI: 1831144047
Provider Name (Legal Business Name): GUTHRIE CLINIC LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 06/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 GUTHRIE SQ
SAYRE PA
18840-1625
US

IV. Provider business mailing address

1 GUTHRIE SQ
SAYRE PA
18840-1625
US

V. Phone/Fax

Practice location:
  • Phone: 570-888-5858
  • Fax: 570-887-2345
Mailing address:
  • Phone: 570-888-5858
  • Fax: 570-887-2345

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number14511501
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code261QE0800X
TaxonomyEndoscopy Clinic/Center
License Number14511501
License Number StatePA

VIII. Authorized Official

Name: MR. JAMES C. ARMSTRONG
Title or Position: CFO
Credential:
Phone: 570-887-3090