Schuylkill Medical Center - East Norwegian Street
Physician Assistant, Surgical in Pottsville, PA. Organization (NPI-2).
NPI number1073710166
StatusActive
Last updated in NPPESOct 16, 2008
Details
- NPI
- 1073710166
- Entity type
- Organization (NPI-2)
- Legal business name
- Schuylkill Medical Center - East Norwegian Street
- Organization subpart
- Yes
- Enumeration date
- Jul 2, 2007
- Last updated
- Oct 16, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AS0400X | Physician Assistant, Surgical | – | PA | Yes |
| 363A00000X | Physician Assistant | – | PA | |
| 367500000X | Nurse Anesthetist, Certified Registered | – | PA |
Other names
- Good Samaritan Regional Medical Center (Former Legal Business Name)
Practice location
700 E Norwegian StPhysican Billing
Pottsville, PA 17901-2710
Phone 570-621-8646
Mailing address
700 E Norwegian StPhysican Billing
Pottsville, PA 17901-2710
Phone 570-621-8646 · Fax 570-621-4316
Authorized official
John E. Simodejka
President & Chief Executive Officer
7176215111
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