Basic Information
| Provider Information | |||||||||
| NPI: | 1669553624 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | GEISINGER WYOMING VALLEY MEDICAL CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5 LAKEVIEW DR | ||||||||
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| City: | MOOSIC | ||||||||
| State: | PA | ||||||||
| PostalCode: | 18705 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5702716211 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1000 E MOUNTAIN BLVD | ||||||||
| Address2: | |||||||||
| City: | WILKES BARRE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 18711 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5708267300 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/18/2006 | ||||||||
| LastUpdateDate: | 03/18/2008 | ||||||||
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| AuthorizedOfficialLastName: | TAPSCOTT | ||||||||
| AuthorizedOfficialFirstName: | BARBARA | ||||||||
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| AuthorizedOfficialTitleorPosition: | VP | ||||||||
| AuthorizedOfficialTelephone: | 5702149773 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 283X00000X | N | Hospitals | Rehabilitation Hospital | 273Y00000X | Y | Hospital Units | Rehabilitation Unit |
No ID Information.