Provider Demographics
NPI:1952392573
Name:GEISINGER HEALTH SYSTEM
Entity Type:Organization
Organization Name:GEISINGER HEALTH SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISOR OF SPORT MED. SERVICES
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HUMEN
Authorized Official - Suffix:
Authorized Official - Credentials:ATC
Authorized Official - Phone:570-820-6086
Mailing Address - Street 1:PO BOX 207
Mailing Address - Street 2:
Mailing Address - City:SHOHOLA
Mailing Address - State:PA
Mailing Address - Zip Code:18458-0207
Mailing Address - Country:US
Mailing Address - Phone:570-559-7253
Mailing Address - Fax:
Practice Address - Street 1:1000 E MOUNTAIN BLVD
Practice Address - Street 2:
Practice Address - City:WILKES BARRE
Practice Address - State:PA
Practice Address - Zip Code:18711-0027
Practice Address - Country:US
Practice Address - Phone:570-820-6086
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART003614282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital