Provider Demographics
NPI:1568650836
Name:THE CARBON-SCHUYLKILL COMMUNITY HOSPITAL, INC.
Entity Type:Organization
Organization Name:THE CARBON-SCHUYLKILL COMMUNITY HOSPITAL, INC.
Other - Org Name:ST. LUKE'S MINERS HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR, SLPHO
Authorized Official - Prefix:MS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:T
Authorized Official - Last Name:ROSKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-954-4132
Mailing Address - Street 1:108 CATAWISSA STREET
Mailing Address - Street 2:
Mailing Address - City:NESQUEHONING
Mailing Address - State:PA
Mailing Address - Zip Code:18240-1511
Mailing Address - Country:US
Mailing Address - Phone:570-669-9990
Mailing Address - Fax:
Practice Address - Street 1:108 CATAWISSA STREET
Practice Address - Street 2:
Practice Address - City:NESQUEHONING
Practice Address - State:PA
Practice Address - Zip Code:18240-1511
Practice Address - Country:US
Practice Address - Phone:570-669-9990
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-11
Last Update Date:2011-05-13
Deactivation Date:2011-02-07
Deactivation Code:
Reactivation Date:2011-05-13
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
393408Medicare Oscar/Certification