Healthcare Provider Details

I. General information

NPI: 1154318871
Provider Name (Legal Business Name): COUNTY OF SCHUYLKILL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2005
Last Update Date: 07/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 UNIVERSITY DR
SCHUYLKILL HAVEN PA
17972-2212
US

IV. Provider business mailing address

401 UNIVERSITY DR
SCHUYLKILL HAVEN PA
17972-2212
US

V. Phone/Fax

Practice location:
  • Phone: 570-385-0331
  • Fax: 570-385-1007
Mailing address:
  • Phone: 570-385-0331
  • Fax: 570-385-1007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number701002
License Number StatePA

VIII. Authorized Official

Name: JILL SCHAEFFER
Title or Position: ADMINISTRATOR
Credential: RN, BSN, NHA
Phone: 570-385-1185