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General NPI Number Information
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NPI Number | 1629050620
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Entity Type | Organization
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Legal Business Name | WILKES-BARRE BEHAVIORAL HOSPITAL COMPANY LLC
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Dates
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Enumeration Date | 11/16/2005
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Last Update Date | 04/26/2021
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Provider Practice Location Address
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Address Line | 562 WYOMING AVE
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City | KINGSTON
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State | PA
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Zip | 18704-3721
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Country | US
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Telephone | 570-552-7500
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Fax | 570-552-7520
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Provider Business Mailing Address
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Address Line | 562 WYOMING AVE
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City | KINGSTON
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State | PA
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Zip | 18704-3721
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Country | US
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Telephone | 570-552-7500
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Fax | 570-552-7520
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Authorized Official
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Title or Position | DIRECTOR/DELEGATED OFFICIAL
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Name | PAULA LALOR
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Credential |
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Telephone | 629-215-3953
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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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 | 3336I0012X
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Taxonomy Name | Institutional Pharmacy
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License Number | PP413699L
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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