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General NPI Number Information
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NPI Number | 1053617118
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Entity Type | Organization
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Legal Business Name | WHITE DEER RUN LLC
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Dates
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Enumeration Date | 02/07/2011
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Last Update Date | 01/20/2026
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Provider Practice Location Address
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Address Line | 520 W 4TH ST
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City | WILLIAMSPORT
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State | PA
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Zip | 17701-6038
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Country | US
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Telephone | 570-322-4836
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Fax | 570-322-4769
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Provider Business Mailing Address
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Address Line | 4020 ASPEN GROVE DR STE 900
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City | FRANKLIN
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State | TN
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Zip | 37067-3134
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Country | US
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Telephone | 615-861-6000
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Fax |
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Authorized Official
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Title or Position | VP AND SECRETARY
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Name | BRIAN P. FARLEY
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Credential |
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Telephone | 615-861-6000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 417040
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License Number State | PA
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