Provider Demographics
NPI:1194725861
Name:MERCY HOSPITAL OF NANTICOKE PA
Entity type:Organization
Organization Name:MERCY HOSPITAL OF NANTICOKE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:H
Authorized Official - Last Name:FRANKO
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:570-348-7074
Mailing Address - Street 1:PO BOX 2040
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18501-2040
Mailing Address - Country:US
Mailing Address - Phone:570-348-7055
Mailing Address - Fax:
Practice Address - Street 1:128 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:NANTICOKE
Practice Address - State:PA
Practice Address - Zip Code:18634-3113
Practice Address - Country:US
Practice Address - Phone:570-348-7055
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA141401282E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007783360010Medicaid
PA1007783360003Medicaid
PA392025Medicare ID - Type UnspecifiedPROVIDER NUMBER
PA1007783360003Medicaid