=====================================================
General NPI Number Information
=====================================================
NPI Number | 1861545683
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GEISINGER LEWISTOWN HOSPITAL
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/18/2007
-----------------------------------------------------
Last Update Date | 06/06/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 400 HIGHLAND AVE
-----------------------------------------------------
City | LEWISTOWN
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 17044-1167
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 717-248-5411
-----------------------------------------------------
Fax | 717-242-7421
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 100 N ACADEMY AVE
-----------------------------------------------------
City | DANVILLE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 17822-4903
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 570-271-6211
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SYSTEM DIRECTOR ENROLLMENT
-----------------------------------------------------
Name | CINDY L MULL
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 570-271-6603
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251K00000X
-----------------------------------------------------
Taxonomy Name | Public Health or Welfare Agency
-----------------------------------------------------
License Number | 121501
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 261Q00000X
-----------------------------------------------------
Taxonomy Name | Clinic/Center
-----------------------------------------------------
License Number | 121501
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 273R00000X
-----------------------------------------------------
Taxonomy Name | Psychiatric Hospital Unit
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 282N00000X
-----------------------------------------------------
Taxonomy Name | General Acute Care Hospital
-----------------------------------------------------
License Number | 121501
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------