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General NPI Number Information
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NPI Number | 1093890360
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Entity Type | Organization
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Legal Business Name | UPMC WILLIAMSPORT
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Dates
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Enumeration Date | 10/26/2006
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Last Update Date | 02/27/2020
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Provider Practice Location Address
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Address Line | 777 RURAL AVE
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City | WILLIAMSPORT
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State | PA
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Zip | 17701-3109
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Country | US
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Telephone | 570-321-1000
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Fax | 570-326-8601
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Provider Business Mailing Address
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Address Line | 1205 GRAMPIAN BLVD 2ND FLOOR
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City | WILLIAMSPORT
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State | PA
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Zip | 17701-1978
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Country | US
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Telephone | 570-326-8676
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Fax | 570-326-8601
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Authorized Official
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Title or Position | EXECUTIVE VP CFO
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Name | MR. CHARLES J SANTANGELO
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Credential | CPA FHFMA
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Telephone | 570-321-3171
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 234601
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License Number State | PA
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