Provider Demographics
NPI:1235138405
Name:LEHIGH VALLEY HOSPITAL SCHUYLKILL
Entity Type:Organization
Organization Name:LEHIGH VALLEY HOSPITAL SCHUYLKILL
Other - Org Name:LEHIGH VALLEY HOSPITAL SCHUYLKILL S JACKSON STREET
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR VP & CFO
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:MARCHOZZI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-862-3943
Mailing Address - Street 1:PO BOX 4120
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18105-4120
Mailing Address - Country:US
Mailing Address - Phone:484-884-0841
Mailing Address - Fax:484-884-3392
Practice Address - Street 1:420 S JACKSON ST
Practice Address - Street 2:
Practice Address - City:POTTSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17901-3625
Practice Address - Country:US
Practice Address - Phone:570-621-5000
Practice Address - Fax:570-622-8221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-19
Last Update Date:2023-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
282N00000X, 282NR1301X
PA421001282NR1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NR1301XHospitalsGeneral Acute Care HospitalRural
No282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100760725Medicaid
PA39-0030OtherCAPITAL BLUE CROSS
PA1497OtherHIGHMARK/BLUE SHIELD
PA39-0030OtherCAPITAL BLUE CROSS