Healthcare Provider Details

I. General information

NPI: 1245667120
Provider Name (Legal Business Name): COMMUNITY HEALTH ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2013
Last Update Date: 10/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

91 HOSPITAL DR
TOWANDA PA
18848-9702
US

IV. Provider business mailing address

91 HOSPITAL DR
TOWANDA PA
18848-9702
US

V. Phone/Fax

Practice location:
  • Phone: 570-268-4713
  • Fax:
Mailing address:
  • Phone: 570-268-4713
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberSP013188
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP013188
License Number StatePA

VIII. Authorized Official

Name: WILLIAM ROHRBACH
Title or Position: CFO
Credential:
Phone: 570-268-2207