Basic Information
| Provider Information | |||||||||
| NPI: | 1225584501 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | POCONO MEDICAL CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 206 E BROWN ST | ||||||||
| Address2: | |||||||||
| City: | EAST STROUDSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 183013006 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5704214000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5683 ROUTE 115 | ||||||||
| Address2: | |||||||||
| City: | BLAKESLEE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 18610 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5704214000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/28/2016 | ||||||||
| LastUpdateDate: | 08/28/2016 | ||||||||
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| AuthorizedOfficialLastName: | SNYDER | ||||||||
| AuthorizedOfficialFirstName: | JEFFREY | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT & CEO | ||||||||
| AuthorizedOfficialTelephone: | 5704262310 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR0206X | Y | Ambulatory Health Care Facilities | Clinic/Center | Radiology, Mammography |
No ID Information.