Organization Name: | MILLER DONMOYER FAMILY HEALTH CENTER LLC |
NPI Number: | 1346541935 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | WAYNE R MILLER (MEMBER) |
Mailing Address: | 255 W Spruce St Shamokin |
State: | PA US |
Postal Code: | 178725811 |
Phone Number: | 5706445050 |
Fax Number: | 5706442798 |
NPI Enumeration Date: | 11/12/2010 |
NPI Last Update Date: | 02/27/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR1300X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Rural Health |
Taxonomy Definition: |