Basic Information
| Provider Information | |||||||||
| NPI: | 1285883553 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CARBON - SCHUYLKILL COMMUNITY HOSPITAL INC | ||||||||
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| OtherOrganizationName: | ST. LUKE'S MINERS HEALTH CENTER HOMETOWN | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 801 OSTRUM ST | ||||||||
| Address2: | |||||||||
| City: | BETHLEHEM | ||||||||
| State: | PA | ||||||||
| PostalCode: | 180151000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6109546048 | ||||||||
| FaxNumber: | 6109546500 | ||||||||
| Practice Location | |||||||||
| Address1: | 34 S RAILROAD ST | ||||||||
| Address2: | |||||||||
| City: | TAMAQUA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 18252 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4845264766 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/11/2008 | ||||||||
| LastUpdateDate: | 11/04/2019 | ||||||||
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| AuthorizedOfficialLastName: | LICHTENWALNER | ||||||||
| AuthorizedOfficialFirstName: | THOMAS | ||||||||
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| AuthorizedOfficialTitleorPosition: | SR VICE PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6109543301 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR1300X | Y | Ambulatory Health Care Facilities | Clinic/Center | Rural Health |
No ID Information.