Provider Demographics
NPI:1083856090
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:AVP - GCHS
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:M
Authorized Official - Last Name:TRIMBLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-271-8120
Mailing Address - Street 1:109 WOODBINE LN
Mailing Address - Street 2:SUITE 2
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17821-9118
Mailing Address - Country:US
Mailing Address - Phone:877-507-4957
Mailing Address - Fax:866-810-6910
Practice Address - Street 1:21 COMMERCE CIR
Practice Address - Street 2:
Practice Address - City:MOUNT POCONO
Practice Address - State:PA
Practice Address - Zip Code:18344-1362
Practice Address - Country:US
Practice Address - Phone:877-507-4957
Practice Address - Fax:866-810-6910
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GEISINGER COMMUNITY HEALTH SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-04-06
Last Update Date:2009-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA045013Medicare UPIN