Provider Demographics
NPI:1346280609
Name:GEISINGER COMMUNITY HEALTH SERVICES
Entity Type:Organization
Organization Name:GEISINGER COMMUNITY HEALTH SERVICES
Other - Org Name:GEISINGER HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:Q
Authorized Official - Last Name:LIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-271-8061
Mailing Address - Street 1:100 N ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-2411
Mailing Address - Country:US
Mailing Address - Phone:570-271-5336
Mailing Address - Fax:570-271-5597
Practice Address - Street 1:109 WOODBINE LN
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:PA
Practice Address - Zip Code:17821-9118
Practice Address - Country:US
Practice Address - Phone:570-271-5336
Practice Address - Fax:570-271-5597
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA16401601251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA136363OtherUNISON PROV #
PA391640OtherCAPITAL BLUE CROSS PROV #
PA1821OtherPA BLUE SHIELD PROV #
PA391640OtherBLACK LUNG PROV #
PA86902OtherGEISINGER HEALTH PLAN #
PA1508343OtherGATEWAY HEALTH PLAN PROV#
PA214114OtherHEALTH AMERICA PROV #
PA5417705OtherAETNA PROVIDER #
PA1000038000021Medicaid
PA391640OtherBCNEPA PROV #
PA391640OtherCAPITAL BLUE CROSS PROV #