Healthcare Provider Details

I. General information

NPI: 1194418616
Provider Name (Legal Business Name): SCHUYLKILL NURSING ASSOCATION INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2023
Last Update Date: 05/31/2023
Certification Date: 05/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 SAINT JOHN ST
SCHUYLKILL HAVEN PA
17972-1720
US

IV. Provider business mailing address

PO BOX 683
SCHUYLKILL HAVEN PA
17972-0683
US

V. Phone/Fax

Practice location:
  • Phone: 570-385-2818
  • Fax:
Mailing address:
  • Phone: 570-385-2818
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: CAITLYN ALVEN
Title or Position: OFFICE COORDINATOR
Credential:
Phone: 570-385-2818