Healthcare Provider Details

I. General information

NPI: 1649687633
Provider Name (Legal Business Name): POST ACUTE MEDICAL AT NANTICOKE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2014
Last Update Date: 04/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

746 JEFFERSON AVE 2ND FLOOR
SCRANTON PA
18510-1624
US

IV. Provider business mailing address

1828 GOOD HOPE RD SUITE 102
ENOLA PA
17025-1233
US

V. Phone/Fax

Practice location:
  • Phone: 570-703-0220
  • Fax:
Mailing address:
  • Phone: 717-731-9660
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282E00000X
TaxonomyLong Term Care Hospital
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: ANTHONY F MISITANO
Title or Position: PRESIDENT
Credential:
Phone: 717-731-9660