Provider Demographics
NPI:1568459436
Name:POCONO MEDICAL CENTER
Entity Type:Organization
Organization Name:POCONO MEDICAL CENTER
Other - Org Name:LEHIGH VALLEY HOSPITAL POCONO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR VP & CFO
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:MARCHOZZI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-862-3943
Mailing Address - Street 1:206 E BROWN ST
Mailing Address - Street 2:
Mailing Address - City:EAST STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18301-3006
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:206 E BROWN ST
Practice Address - Street 2:
Practice Address - City:EAST STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18301-3006
Practice Address - Country:US
Practice Address - Phone:570-420-4923
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-05
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
273R00000X
PA072001282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA64492OtherMED PLUS(THREE RIVERS HP)
PA0001455OtherAETNA
PA1007723970001Medicaid
PA25761OtherGEISINGER HEALTH PLAN
PA1007723970013Medicaid
PA1007723970024Medicaid
PA1007723970002Medicaid
PA1007723970014Medicaid
PA390201OtherBLUE CROSS
PA39S201OtherPSYCH
PA800053OtherFIRST PRIORITY HEALTH
PA390201OtherBLUE CROSS