Organization Name: | COMMUNITY HEALTH CARE RURAL HEALTH CLINIC, LLC |
NPI Number: | 1104284751 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | NADINE MARKOVICH-STEN (MEMBER / ADMINISTRATIVE DIRECTOR) |
Mailing Address: | 550 W Walnut St Shamokin |
State: | PA US |
Postal Code: | 178725226 |
Phone Number: | 5706442222 |
Fax Number: | 5706484705 |
NPI Enumeration Date: | 02/10/2016 |
NPI Last Update Date: | 02/10/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR1300X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Rural Health |
Taxonomy Definition: |