Provider Demographics
NPI:1326096744
Name:EVANGELICAL COMMUNITY HOSPITAL
Entity Type:Organization
Organization Name:EVANGELICAL COMMUNITY HOSPITAL
Other - Org Name:EVANGELICAL COMMUNITY HOSP INPATIENT REHAB UNIT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:KENDRA
Authorized Official - Middle Name:A
Authorized Official - Last Name:AUCKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-522-2000
Mailing Address - Street 1:1 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17837-9350
Mailing Address - Country:US
Mailing Address - Phone:570-522-2938
Mailing Address - Fax:570-522-2083
Practice Address - Street 1:1 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:PA
Practice Address - Zip Code:17837-9350
Practice Address - Country:US
Practice Address - Phone:570-522-2938
Practice Address - Fax:570-522-2083
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EVANGELICAL COMMUNITY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-05
Last Update Date:2016-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA570201283X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283X00000XHospitalsRehabilitation Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA39T013OtherCAPITAL BLUE CROSS
PA12800OtherGEISINGER HEALTH PLAN
PA8769OtherHEALTH AMERICA
PA1863OtherBLUE SHIELD HIGHMARK
PA1863OtherBLUE SHIELD HIGHMARK