Provider Demographics
NPI:1184783045
Name:JOSEPH W SCOTCHLAS FUNERAL HOME INC.
Entity type:Organization
Organization Name:JOSEPH W SCOTCHLAS FUNERAL HOME INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT FUNERAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:W
Authorized Official - Last Name:SCOTCHLAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-282-3090
Mailing Address - Street 1:621 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SIMPSON
Mailing Address - State:PA
Mailing Address - Zip Code:18407-1307
Mailing Address - Country:US
Mailing Address - Phone:570-282-3090
Mailing Address - Fax:570-282-3899
Practice Address - Street 1:621 MAIN ST
Practice Address - Street 2:
Practice Address - City:SIMPSON
Practice Address - State:PA
Practice Address - Zip Code:18407-1307
Practice Address - Country:US
Practice Address - Phone:570-282-3090
Practice Address - Fax:570-282-3899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA012735-L251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101490750 0001Medicaid