Provider Demographics
NPI:1518948157
Name:MOSES TAYLOR HOSPITAL
Entity Type:Organization
Organization Name:MOSES TAYLOR HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:J
Authorized Official - Last Name:TOOMEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-340-2983
Mailing Address - Street 1:PO BOX 1270
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18501-1270
Mailing Address - Country:US
Mailing Address - Phone:570-340-2983
Mailing Address - Fax:570-340-2243
Practice Address - Street 1:700 QUINCY AVE
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18510-1724
Practice Address - Country:US
Practice Address - Phone:570-340-2983
Practice Address - Fax:570-340-2243
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA133801282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
300742OtherUS DEPARTMENT OF LABOR
56117OtherTHREE RIVERS
P019044OtherCHAMPUS
PA10077714100Medicaid
NY00579451Medicaid
NJ4193601Medicaid
68671OtherTHREE RIVERS
76975OtherTHREE RIVERS
56117OtherTHREE RIVERS