Healthcare Provider Details

I. General information

NPI: 1346895588
Provider Name (Legal Business Name): MEREDITH LILLIAN HAMILL MS, ATC, NRP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2019
Last Update Date: 08/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 REMINGTON AVE
SCRANTON PA
18505-1118
US

IV. Provider business mailing address

450 ALDEN RD
HONESDALE PA
18431-4009
US

V. Phone/Fax

Practice location:
  • Phone: 570-207-5200
  • Fax:
Mailing address:
  • Phone: 336-263-5693
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License Number212383
License Number StatePA

VII. Legacy identifiers

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: