MEDICARE: GEISINGER COMMUNITY HEALTH SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251G00000X	Community Based Hospice Care Agency	153399	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	1464	OTHER	PA	BLUE SHIELD HOSPICE
3	391902	OTHER	PA	BLUE CROSS HOSPICE

General Provider Information

NPI Number	:	1477559276
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GEISINGER COMMUNITY HEALTH SERVICES

Provider Business Mailing Address
First Line	:	410 GLENN AVE
Second Line	:	SUITE 200
City	:	BLOOMSBURG
State	:	PA
Zip	:	17815-1200
Country	:	US
Telephone Number	:	570-784-1723
Fax Number	:	570-784-8512

Provider Business Practice Location Address
First Line	:	410 GLENN AVE
Second Line	:	SUITE 200
City	:	BLOOMSBURG
State	:	PA
Zip	:	17815-1200
Country	:	US
Telephone Number	:	570-784-1723
Fax Number	:	570-784-8512

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	MRS. DENISE PRINCE
Credential	:
Telephone Number	:	570-214-9492

Provider Enumeration Date	:	06/27/2005
Last Update Date	:	05/18/2015

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Directions to “GEISINGER COMMUNITY HEALTH SERVICES ” Practice Location

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