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General NPI Number Information
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NPI Number | 1366407587
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Entity Type | Organization
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Legal Business Name | GEISINGER JERSEY SHORE HOSPITAL
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Dates
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Enumeration Date | 04/19/2006
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Last Update Date | 12/10/2024
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Provider Practice Location Address
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Address Line | 1020 THOMPSON ST
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City | JERSEY SHORE
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State | PA
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Zip | 17740-1729
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Country | US
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Telephone | 570-398-0100
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Fax | 570-398-4412
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Provider Business Mailing Address
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Address Line | 100 N ACADEMY AVE
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City | DANVILLE
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State | PA
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Zip | 17822-4903
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Country | US
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Telephone | 570-271-6144
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Fax | 570-271-6578
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Authorized Official
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Title or Position | SYSTEM DIRECTOR CREDENENROLLMENTS
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Name | CINDY L MULL
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Credential |
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Telephone | 570-271-6603
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number | 101401
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License Number State | PA
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