Provider Demographics
NPI:1063468643
Name:GEISINGER COMMUNITY HEALTH SERVICES
Entity Type:Organization
Organization Name:GEISINGER COMMUNITY HEALTH SERVICES
Other - Org Name:CAREWORKS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:Q
Authorized Official - Last Name:LIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-271-8120
Mailing Address - Street 1:100 N ACADEMY AVE
Mailing Address - Street 2:M.C. 25-01
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-9800
Mailing Address - Country:US
Mailing Address - Phone:570-271-6600
Mailing Address - Fax:570-271-5537
Practice Address - Street 1:500 SCOTT ST
Practice Address - Street 2:
Practice Address - City:WILKES BARRE
Practice Address - State:PA
Practice Address - Zip Code:18702-5613
Practice Address - Country:US
Practice Address - Phone:570-829-7870
Practice Address - Fax:570-829-7938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA=========OtherTAX ID