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General NPI Number Information
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NPI Number | 1285718312
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Entity Type | Organization
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Legal Business Name | DIVINE PROVIDENCE HOSPITAL OF THE SISTERS OF CHRISTIAN CHARITY
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 07/25/2016
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Provider Practice Location Address
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Address Line | 1100 GRAMPIAN BLVD
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City | WILLIAMSPORT
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State | PA
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Zip | 17701-1909
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Country | US
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Telephone | 570-326-8000
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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 VICE PRESIDENT CFO, CPO
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Name | MR. ERIC D POHJALA
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Credential | FHFMA, FACHE
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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 | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 041001
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License Number State | PA
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