| Organization Name: | JERSEY SHORE HOSPITAL |
| NPI Number: | 1194868729 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARK A. O'NEILL (CFO) |
| Mailing Address: | 1020 Thompson St Jersey Shore |
| State: | PA US |
| Postal Code: | 177401729 |
| Phone Number: | 5703980100 |
| Fax Number: | 5703984412 |
| NPI Enumeration Date: | 02/14/2007 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | 101401 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |