MEDICARE: GUTHRIE CLINIC, LTD.

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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1760674873
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GUTHRIE CLINIC, LTD.

Provider Business Mailing Address
First Line	:	1 GUTHRIE SQ
Second Line	:
City	:	SAYRE
State	:	PA
Zip	:	18840-1625
Country	:	US
Telephone Number	:	570-888-5858
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 1ST ST
Second Line	:
City	:	WATKINS GLEN
State	:	NY
Zip	:	14891-1260
Country	:	US
Telephone Number	:	607-535-2403
Fax Number	:

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	MR. JAMES C ARMSTRONG
Credential	:
Telephone Number	:	570-882-3280

Provider Enumeration Date	:	08/13/2007
Last Update Date	:	01/02/2008

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