Healthcare Provider Details

I. General information

NPI: 1598911992
Provider Name (Legal Business Name): THE CARBON SCHUYLKILL COMMUNITY HOSPITAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2008
Last Update Date: 03/24/2020
Certification Date: 03/24/2020
Deactivation Date: 03/16/2011
Reactivation Date: 04/22/2011

III. Provider practice location address

34 S RAILROAD ST
TAMAQUA PA
18252-1927
US

IV. Provider business mailing address

34 S RAILROAD ST
TAMAQUA PA
18252-1927
US

V. Phone/Fax

Practice location:
  • Phone: 570-645-1950
  • Fax: 570-645-1955
Mailing address:
  • Phone: 570-645-1950
  • Fax: 570-645-1955

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number036801
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. THOMAS P. LICHTENWALNER
Title or Position: S.V.P FINANCE
Credential:
Phone: 610-954-3301