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General NPI Number Information
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NPI Number | 1639447543
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Entity Type | Organization
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Legal Business Name | PECKVILLE HOSPITAL COMPANY LLC
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Dates
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Enumeration Date | 12/06/2011
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Last Update Date | 12/02/2013
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Provider Practice Location Address
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Address Line | 1400 MAIN ST
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City | PECKVILLE
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State | PA
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Zip | 18452-2009
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Country | US
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Telephone | 570-340-2983
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Fax |
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Provider Business Mailing Address
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Address Line | 1400 MAIN ST
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City | PECKVILLE
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State | PA
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Zip | 18452-2009
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Country | US
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Telephone | 570-340-2983
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Fax |
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Authorized Official
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Title or Position | AUTH OFFICIAL / DIR BO SUP
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Name | LAURIE HOLTSFORD
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Credential |
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Telephone | 615-465-7466
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number |
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License Number State |
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