Provider Demographics
NPI:1083670939
Name:CARBON SCHUYLKILL ENDOSCOPY CENTER,INC
Entity Type:Organization
Organization Name:CARBON SCHUYLKILL ENDOSCOPY CENTER,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:L
Authorized Official - Last Name:SENSINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-379-0443
Mailing Address - Street 1:400 SOUTH 9TH STREET
Mailing Address - Street 2:
Mailing Address - City:LEHIGHTON
Mailing Address - State:PA
Mailing Address - Zip Code:18235
Mailing Address - Country:US
Mailing Address - Phone:610-379-0443
Mailing Address - Fax:610-379-0587
Practice Address - Street 1:400 SOUTH 9TH STREET
Practice Address - Street 2:
Practice Address - City:LEHIGHTON
Practice Address - State:PA
Practice Address - Zip Code:18235
Practice Address - Country:US
Practice Address - Phone:610-379-0443
Practice Address - Fax:610-379-0587
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA17221501261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1009644200001Medicaid
Y01999Medicare UPIN
PA1009644200001Medicaid