Provider Demographics
NPI:1205817830
Name:COMMUNITY MEDICAL CENTER TCU
Entity Type:Organization
Organization Name:COMMUNITY MEDICAL CENTER TCU
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NHA
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:PALMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-969-7276
Mailing Address - Street 1:1800 MULBERRY ST
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18510-2369
Mailing Address - Country:US
Mailing Address - Phone:570-969-7276
Mailing Address - Fax:570-969-8785
Practice Address - Street 1:1800 MULBERRY ST
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18510-2369
Practice Address - Country:US
Practice Address - Phone:570-969-7276
Practice Address - Fax:570-969-8785
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA037102314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA396030Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER