Provider Demographics
NPI:1578582516
Name:COLUMBIA MONTOUR FAMILY HEALTH
Entity Type:Organization
Organization Name:COLUMBIA MONTOUR FAMILY HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SWANEE
Authorized Official - Middle Name:BARBARA
Authorized Official - Last Name:MARCUS
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:570-387-0236
Mailing Address - Street 1:2201 5TH STREET HOLLOW RAOD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BLOOMSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17815
Mailing Address - Country:US
Mailing Address - Phone:570-387-0236
Mailing Address - Fax:570-784-1942
Practice Address - Street 1:2201 5TH STREET HOLLOW ROAD
Practice Address - Street 2:SUITE 1
Practice Address - City:BLOOMSBURG
Practice Address - State:PA
Practice Address - Zip Code:17815
Practice Address - Country:US
Practice Address - Phone:570-387-0236
Practice Address - Fax:570-784-1942
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility
Not Answered363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Multi-Specialty