Provider Demographics
NPI:1275672164
Name:TWO RIVERS HOSPITAL CORPORATION
Entity Type:Organization
Organization Name:TWO RIVERS HOSPITAL CORPORATION
Other - Org Name:NURSE FAMILY PARTNERSHIP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:F
Authorized Official - Last Name:DY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:610-250-4797
Mailing Address - Street 1:250 S 21ST ST
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18042-3851
Mailing Address - Country:US
Mailing Address - Phone:610-250-4797
Mailing Address - Fax:610-250-4938
Practice Address - Street 1:250 S 21ST ST
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18042-3851
Practice Address - Country:US
Practice Address - Phone:610-250-4797
Practice Address - Fax:610-250-4938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007548080046Medicaid