Provider Demographics
NPI:1346333903
Name:EVANGELICAL COMMUNITY HOSPITAL PHARMACY & HOME CARE PRODUCTS INC.
Entity Type:Organization
Organization Name:EVANGELICAL COMMUNITY HOSPITAL PHARMACY & HOME CARE PRODUCTS INC.
Other - Org Name:HOME CARE PRODUCTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP/CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KENDRA
Authorized Official - Middle Name:A
Authorized Official - Last Name:AUCKER
Authorized Official - Suffix:
Authorized Official - Credentials:VP/CHIEF OPERATING O
Authorized Official - Phone:570-522-2807
Mailing Address - Street 1:ONE HOSPITAL DRIVE
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:570-522-2585
Mailing Address - Fax:570-522-2819
Practice Address - Street 1:7105 WEST BRANCH HIGHWAY
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:570-522-2585
Practice Address - Fax:570-522-2819
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EVANGELICAL MEDICAL SERVICES ORGANIZATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-02
Last Update Date:2012-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA8000001283332B00000X
332BC3200X, 332BP3500X, 332BX2000X, 335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007786860002Medicaid
PA1007786860002Medicaid