Provider Demographics
NPI:1245258649
Name:POCONO MEDICAL CENTER
Entity type:Organization
Organization Name:POCONO MEDICAL CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:RAGONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-420-4970
Mailing Address - Street 1:206 E BROWN ST
Mailing Address - Street 2:POCONO HEALTHCARE MGMT. - PROFESIONAL BLDG.
Mailing Address - City:E STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18301-3006
Mailing Address - Country:US
Mailing Address - Phone:570-420-4951
Mailing Address - Fax:570-476-3754
Practice Address - Street 1:200 E BROWN ST
Practice Address - Street 2:SUITE B
Practice Address - City:E STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18301-3006
Practice Address - Country:US
Practice Address - Phone:570-420-6220
Practice Address - Fax:570-420-6221
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:POCONO MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-17
Last Update Date:2014-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Multi-Specialty