Provider Demographics
NPI:1013208420
Name:MATERNAL & FAMILY HEALTH SERVICES INC
Entity Type:Organization
Organization Name:MATERNAL & FAMILY HEALTH SERVICES INC
Other - Org Name:CIRCLE OF CARE
Other - Org Type:Other Name
Authorized Official - Title/Position:VICE PRESIDENT OF FINANCE & PLANNIN
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:GERMINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-826-1777
Mailing Address - Street 1:15 PUBLIC SQ
Mailing Address - Street 2:STE 600
Mailing Address - City:WILKES BARRE
Mailing Address - State:PA
Mailing Address - Zip Code:18701-1702
Mailing Address - Country:US
Mailing Address - Phone:570-826-1777
Mailing Address - Fax:570-823-3040
Practice Address - Street 1:8 SILK MILL DR
Practice Address - Street 2:STE 226
Practice Address - City:HAWLEY
Practice Address - State:PA
Practice Address - Zip Code:18428-1483
Practice Address - Country:US
Practice Address - Phone:570-826-1777
Practice Address - Fax:570-823-3040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-20
Last Update Date:2016-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD055164L261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0015798710009Medicaid
PA1025690210002Medicaid
PA1026261910003Medicaid
PA1007678420039Medicaid
PA1025989180002Medicaid
PA1025995680004Medicaid
PA1026041580003Medicaid