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General NPI Number Information
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NPI Number | 1043392020
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Entity Type | Organization
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Legal Business Name | NORTH PENN COMPREHENSIVE HEALTH SERVICES
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Dates
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Enumeration Date | 10/19/2006
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Last Update Date | 12/06/2018
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Provider Practice Location Address
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Address Line | 103 WEST AVE WELLSBORO LAUREL HEALTH CENTER
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City | WELLSBORO
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State | PA
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Zip | 16901-1358
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Country | US
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Telephone | 570-724-1010
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Fax | 570-724-3970
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Provider Business Mailing Address
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Address Line | 7 WATER ST
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City | WELLSBORO
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State | PA
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Zip | 16901-1126
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Country | US
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Telephone | 570-662-1955
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | RONALD MERYL GILBERT JR.
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Credential |
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Telephone | 570-662-1955
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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