Provider Demographics
NPI:1598911992
Name:THE CARBON SCHUYLKILL COMMUNITY HOSPITAL, INC.
Entity Type:Organization
Organization Name:THE CARBON SCHUYLKILL COMMUNITY HOSPITAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:S.V.P FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:P
Authorized Official - Last Name:LICHTENWALNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-954-3301
Mailing Address - Street 1:34 S RAILROAD ST
Mailing Address - Street 2:
Mailing Address - City:TAMAQUA
Mailing Address - State:PA
Mailing Address - Zip Code:18252-1927
Mailing Address - Country:US
Mailing Address - Phone:570-645-1950
Mailing Address - Fax:570-645-1955
Practice Address - Street 1:34 S RAILROAD ST
Practice Address - Street 2:
Practice Address - City:TAMAQUA
Practice Address - State:PA
Practice Address - Zip Code:18252-1927
Practice Address - Country:US
Practice Address - Phone:570-645-1950
Practice Address - Fax:570-645-1955
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE CARBON SCHUYLKILL COMMUNITY HOSPITAL, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-08-18
Last Update Date:2020-03-24
Deactivation Date:2011-03-16
Deactivation Code:
Reactivation Date:2011-04-22
Provider Licenses
StateLicense IDTaxonomies
PA036801261QR1300X
261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health