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General NPI Number Information
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NPI Number | 1205206943
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Entity Type | Organization
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Legal Business Name | EVANGELICAL MEDICAL SERVICES ORGANIZATION
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Dates
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Enumeration Date | 10/06/2015
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Last Update Date | 09/09/2024
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Provider Practice Location Address
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Address Line | 1 HOSPITAL DR
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City | LEWISBURG
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State | PA
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Zip | 17837-9350
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Country | US
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Telephone | 570-522-2000
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Fax | 570-768-3911
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Provider Business Mailing Address
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Address Line | 1 HOSPITAL DR SUITE 306
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City | LEWISBURG
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State | PA
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Zip | 17837-9350
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Country | US
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Telephone | 570-522-4110
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Fax | 570-768-3911
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Authorized Official
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Title or Position | SENIOR VICE PRESIDENT/PRESIDENT
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Name | KENDRA A AUCKER
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Credential |
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Telephone | 570-522-2501
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State | PA
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