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General NPI Number Information
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NPI Number | 1568503449
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Entity Type | Organization
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Legal Business Name | SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET SPU
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Dates
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Enumeration Date | 02/12/2007
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Last Update Date | 01/09/2025
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Provider Practice Location Address
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Address Line | 420 S JACKSON ST
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City | POTTSVILLE
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State | PA
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Zip | 17901-3625
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Country | US
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Telephone | 570-621-5142
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Fax | 570-621-5113
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Provider Business Mailing Address
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Address Line | 420 S JACKSON ST
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City | POTTSVILLE
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State | PA
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Zip | 17901-3625
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Country | US
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Telephone | 570-621-5142
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Fax | 570-621-5113
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Authorized Official
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Title or Position | SR VP & CFO
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Name | THOMAS MARCHOZZI
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Credential |
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Telephone | 484-862-3943
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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 |
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License Number State | PA
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