| Organization Name: | DIVINE PROVIDENCE HOSPITAL OF THE SISTERS OF CHRISTIAN CHARITY |
| NPI Number: | 1023110459 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CHARLES J. SANTANGELO (EXECUTIVE VP CFO) |
| Mailing Address: | 21 Susquehanna Valley Mall Drive Suite D Selinsgrove |
| State: | PA US |
| Postal Code: | 17870 |
| Phone Number: | 5703745454 |
| Fax Number: | 5703268601 |
| NPI Enumeration Date: | 09/05/2006 |
| NPI Last Update Date: | 04/20/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QE0700X |
| License Number: | 041001 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | End-Stage Renal Disease (ESRD) Treatment |
| Taxonomy Definition: | |