Provider Demographics
NPI:1730479064
Name:SCRANTON HOSPITAL COMPANY LLC
Entity Type:Organization
Organization Name:SCRANTON HOSPITAL COMPANY LLC
Other - Org Name:REGIONAL HOSPITAL OF SCRANTON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUTH OFFICIAL/DIR BUS OFFICE SUPPOR
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLTSFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-465-7466
Mailing Address - Street 1:746 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18510-1624
Mailing Address - Country:US
Mailing Address - Phone:570-348-7100
Mailing Address - Fax:570-348-7696
Practice Address - Street 1:746 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18510-1624
Practice Address - Country:US
Practice Address - Phone:570-348-7100
Practice Address - Fax:570-348-7696
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SCRANTON HOSPITAL COMPANY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-04-07
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA395930Medicare Oscar/Certification