Provider Demographics
NPI:1720673411
Name:COLUMBIA ANCILLARY SERVICES INC
Entity Type:Organization
Organization Name:COLUMBIA ANCILLARY SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:KLINGERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-784-0111
Mailing Address - Street 1:1388 STATE RT 487
Mailing Address - Street 2:
Mailing Address - City:BLOOMSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17815-8953
Mailing Address - Country:US
Mailing Address - Phone:570-784-1410
Mailing Address - Fax:570-784-0864
Practice Address - Street 1:6850 LOWS RD
Practice Address - Street 2:SUITE 315
Practice Address - City:BLOOMSBURG
Practice Address - State:PA
Practice Address - Zip Code:17815-8708
Practice Address - Country:US
Practice Address - Phone:570-784-5300
Practice Address - Fax:570-784-5301
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COLUMBIA ANCILLARY SERVICES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-03-04
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies