Provider Demographics
NPI:1174687420
Name:BARNES-KASSON COUNTY HOSPITAL
Entity Type:Organization
Organization Name:BARNES-KASSON COUNTY HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF FINANCE
Authorized Official - Prefix:MISS
Authorized Official - First Name:SARA
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:IVESON
Authorized Official - Suffix:
Authorized Official - Credentials:ESQ
Authorized Official - Phone:570-853-3135
Mailing Address - Street 1:400 TURNPIKE ST
Mailing Address - Street 2:
Mailing Address - City:SUSQUEHANNA
Mailing Address - State:PA
Mailing Address - Zip Code:18847-1638
Mailing Address - Country:US
Mailing Address - Phone:570-853-3135
Mailing Address - Fax:570-853-3008
Practice Address - Street 1:400 TURNPIKE ST
Practice Address - Street 2:
Practice Address - City:SUSQUEHANNA
Practice Address - State:PA
Practice Address - Zip Code:18847-1638
Practice Address - Country:US
Practice Address - Phone:570-853-3135
Practice Address - Fax:570-853-3008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007276220024Medicaid