Healthcare Provider Details

I. General information

NPI: 1740669530
Provider Name (Legal Business Name): MATERNAL & FAMILY HEALTH SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2015
Last Update Date: 01/09/2024
Certification Date: 01/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 S WASHINGTON AVE
SCRANTON PA
18510-3808
US

IV. Provider business mailing address

15 PUBLIC SQ STE 600
WILKES BARRE PA
18701-1704
US

V. Phone/Fax

Practice location:
  • Phone: 570-961-5550
  • Fax: 570-823-3040
Mailing address:
  • Phone: 570-826-1777
  • Fax: 570-823-3040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License NumberMD055164L
License Number StatePA

VII. Legacy identifiers

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

# 1
Identifier1025989180004
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer
# 2
Identifier1026041580002
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer
# 3
Identifier0016466420006
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer
# 4
Identifier1025995680003
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer
# 5
Identifier1007678420050
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer
# 6
Identifier0015798710009
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer
# 7
Identifier1007678420043
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer
# 8
Identifier1025690210003
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer
# 9
Identifier1026261910006
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer

VIII. Authorized Official

Name: MARGARET MANLEY
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 570-826-1777