Provider Demographics
NPI:1811939978
Name:GEISINGER COMMUNITY HEALTH SERVICES
Entity type:Organization
Organization Name:GEISINGER COMMUNITY HEALTH SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:Q
Authorized Official - Last Name:LIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-271-8120
Mailing Address - Street 1:100 N ACADEMY AVE
Mailing Address - Street 2:MC 35-58
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-9800
Mailing Address - Country:US
Mailing Address - Phone:570-826-7811
Mailing Address - Fax:570-825-1018
Practice Address - Street 1:1546 HIGHWAY 315
Practice Address - Street 2:
Practice Address - City:WILKES BARRE
Practice Address - State:PA
Practice Address - Zip Code:18702-7005
Practice Address - Country:US
Practice Address - Phone:570-826-7811
Practice Address - Fax:570-825-1018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP415000L251F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251F00000XAgenciesHome Infusion
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1000038000025Medicaid
PA996012OtherBCNEPA PROVIDER NUMBER
PA1507155OtherGATEWAY PROVIDER #
PA243353OtherHIGHMARK BS PROVIDER #
PA132447OtherUNISON HEALTH PLAN
PA181925OtherBC NEPA ACCESS CARE PROV#
PAGE205242OtherGEISINGER HEALTH PLAN HMO
PA09HI10OtherCAPITAL BLUE CROSS PROVID
PA362013OtherAETNA PROVIDER NUMBER
PA39JI10OtherKEYSTONE HEALTH CENTRAL
PA95862OtherHEALTH AMERICA PROVIDER #
PA1000038000025Medicaid