Provider Demographics
NPI:1972667343
Name:NORTHEASTERN PENNSYLVANIA HEALTH CORPORATION
Entity Type:Organization
Organization Name:NORTHEASTERN PENNSYLVANIA HEALTH CORPORATION
Other - Org Name:LEHIGH VALLEY HOME CARE HAZLETON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EVP & CFO
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:MARCHOZZI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-862-3943
Mailing Address - Street 1:766 E BROAD ST
Mailing Address - Street 2:
Mailing Address - City:HAZLETON
Mailing Address - State:PA
Mailing Address - Zip Code:18201-6835
Mailing Address - Country:US
Mailing Address - Phone:570-501-4987
Mailing Address - Fax:570-501-4969
Practice Address - Street 1:766 E BROAD ST
Practice Address - Street 2:
Practice Address - City:HAZLETON
Practice Address - State:PA
Practice Address - Zip Code:18201-6835
Practice Address - Country:US
Practice Address - Phone:570-501-4987
Practice Address - Fax:570-501-4969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA083701251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA397455Medicare ID - Type UnspecifiedHI-TECH HOME CARE