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General NPI Number Information
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NPI Number | 1346571676
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Entity Type | Organization
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Legal Business Name | INSTITUTE OF PALLIATIVE MEDICINE PC
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Dates
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Enumeration Date | 01/27/2010
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Last Update Date | 01/27/2010
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Provider Practice Location Address
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Address Line | 1 COUNTRY CLUB PL
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City | SOUTH ABINGTON TOWNSHIP
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State | PA
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Zip | 18411-9199
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Country | US
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Telephone | 570-586-8990
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Fax |
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Provider Business Mailing Address
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Address Line | 1 COUNTRY CLUB PL
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City | SOUTH ABINGTON TOWNSHIP
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State | PA
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Zip | 18411-9199
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Country | US
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Telephone | 570-586-8990
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. VINCENT J VANSTON
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Credential | M.D.
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Telephone | 570-586-8990
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
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License Number | MD-046153-L
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License Number State | PA
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