Provider Demographics
NPI:1518256726
Name:TUNKHANNOCK HOSPITAL COMPANY LLC
Entity Type:Organization
Organization Name:TUNKHANNOCK HOSPITAL COMPANY LLC
Other - Org Name:TYLER MEMORIAL HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR/DELEGATED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:LALOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:629-215-3953
Mailing Address - Street 1:880 SR 6 W
Mailing Address - Street 2:
Mailing Address - City:TUNKHANNOCK
Mailing Address - State:PA
Mailing Address - Zip Code:18657-6149
Mailing Address - Country:US
Mailing Address - Phone:570-836-6236
Mailing Address - Fax:570-836-7057
Practice Address - Street 1:5950 SR 6
Practice Address - Street 2:
Practice Address - City:TUNKHANNOCK
Practice Address - State:PA
Practice Address - Zip Code:18657-7905
Practice Address - Country:US
Practice Address - Phone:570-836-6236
Practice Address - Fax:570-836-7057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-29
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
390192Medicare Oscar/Certification