Healthcare Provider Details

I. General information

NPI: 1124405592
Provider Name (Legal Business Name): GEISINGER VIEWMONT IMAGING, A SERVICE OF GCMC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2015
Last Update Date: 03/10/2023
Certification Date: 03/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

475 MORGAN HWY
SCRANTON PA
18508-2605
US

IV. Provider business mailing address

100 N ACADEMY AVE
DANVILLE PA
17822-4903
US

V. Phone/Fax

Practice location:
  • Phone: 570-334-7484
  • Fax: 570-334-7492
Mailing address:
  • Phone: 570-271-6144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number StatePA

VIII. Authorized Official

Name: MS. CINDY L MULL
Title or Position: DIRECTOR SYSTEM CREDENTIALING
Credential:
Phone: 570-271-6144