Healthcare Provider Details

I. General information

NPI: 1467592576
Provider Name (Legal Business Name): MERCY HOSPITAL SCRANTON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

746 JEFFERSON AVE
SCRANTON PA
18510-1624
US

IV. Provider business mailing address

746 JEFFERSON AVE
SCRANTON PA
18510-1624
US

V. Phone/Fax

Practice location:
  • Phone: 570-348-7100
  • Fax: 570-348-7696
Mailing address:
  • Phone: 570-348-7100
  • Fax: 570-348-7696

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VII. Legacy identifiers

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

# 1
Identifier1007467710021
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer

VIII. Authorized Official

Name: MR. STEVE H FRANKO
Title or Position: CFO
Credential:
Phone: 570-348-7074