Provider Demographics
NPI:1649271842
Name:LEHIGH VALLEY HOSPITAL - SCHUYLKILL
Entity type:Organization
Organization Name:LEHIGH VALLEY HOSPITAL - SCHUYLKILL
Other - Org Name:<UNAVAIL>
Other - Org Type:
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 1:420 S JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:POTTSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17901-3625
Mailing Address - Country:US
Mailing Address - Phone:570-621-5000
Mailing Address - Fax:570-622-8221
Practice Address - Street 1:420 S JACKSON ST
Practice Address - Street 2:
Practice Address - City:POTTSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17901-3625
Practice Address - Country:US
Practice Address - Phone:570-621-5000
Practice Address - Fax:570-622-8221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-10
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA421001207ZP0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1364071OtherBLUE SHIELD - PATHOLOGY
PA1364071OtherBLUE SHIELD - PATHOLOGY