Provider Demographics
NPI:1942525001
Name:MATERNAL & FAMILY HEALTH SERVICES, INC
Entity Type:Organization
Organization Name:MATERNAL & FAMILY HEALTH SERVICES, INC
Other - Org Name:LEHIGH VALLEY FAMILY PLANNING
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:W
Authorized Official - Last Name:MACKEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-826-1777
Mailing Address - Street 1:15 PUBLIC SQ
Mailing Address - Street 2:SUITE 600
Mailing Address - City:WILKES BARRE
Mailing Address - State:PA
Mailing Address - Zip Code:18701-1702
Mailing Address - Country:US
Mailing Address - Phone:570-826-1777
Mailing Address - Fax:570-823-3040
Practice Address - Street 1:1227 W LIBERTY ST
Practice Address - Street 2:LIBERTY PLAZA, SUITE 104
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18102-2604
Practice Address - Country:US
Practice Address - Phone:610-432-3455
Practice Address - Fax:610-432-1221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-01
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD055164L261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007678420037Medicaid
PA1026262170001Medicaid