Provider Demographics
NPI:1477559276
Name:GEISINGER COMMUNITY HEALTH SERVICES
Entity Type:Organization
Organization Name:GEISINGER COMMUNITY HEALTH SERVICES
Other - Org Name:COLUMBIA MONTOUR HOSIPCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:PRINCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-214-9492
Mailing Address - Street 1:410 GLENN AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BLOOMSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17815-1200
Mailing Address - Country:US
Mailing Address - Phone:570-784-1723
Mailing Address - Fax:570-784-8512
Practice Address - Street 1:410 GLENN AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:BLOOMSBURG
Practice Address - State:PA
Practice Address - Zip Code:17815-1200
Practice Address - Country:US
Practice Address - Phone:570-784-1723
Practice Address - Fax:570-784-8512
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-27
Last Update Date:2015-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA153399251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007466820008Medicaid
PA1464OtherBLUE SHIELD HOSPICE
PA391902OtherBLUE CROSS HOSPICE
PA391902OtherBLUE CROSS HOSPICE