Provider Demographics
NPI:1356407373
Name:ENDLESS MOUNTAINS HEALTH SYSTEMS
Entity type:Organization
Organization Name:ENDLESS MOUNTAINS HEALTH SYSTEMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:LOREN
Authorized Official - Middle Name:L
Authorized Official - Last Name:STONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-278-3801
Mailing Address - Street 1:100 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:PA
Mailing Address - Zip Code:18801-6402
Mailing Address - Country:US
Mailing Address - Phone:570-278-3801
Mailing Address - Fax:570-278-3648
Practice Address - Street 1:100 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:PA
Practice Address - Zip Code:18801-6402
Practice Address - Country:US
Practice Address - Phone:570-278-3801
Practice Address - Fax:570-278-3648
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ENDLESS MOUNTAINS HEALTH SYSTEMS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-28
Last Update Date:2016-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100737306 0007Medicaid