Provider Demographics
NPI:1215918560
Name:ENDLESS MOUNTAINS HEALTH SYSTEMS, INC.
Entity type:Organization
Organization Name:ENDLESS MOUNTAINS HEALTH SYSTEMS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:REXFORD
Authorized Official - Middle Name:O
Authorized Official - Last Name:CATLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-278-3801
Mailing Address - Street 1:25 GROW AVE
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:PA
Mailing Address - Zip Code:18801-1106
Mailing Address - Country:US
Mailing Address - Phone:570-278-3801
Mailing Address - Fax:570-278-3648
Practice Address - Street 1:100 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:PA
Practice Address - Zip Code:18801-6402
Practice Address - Country:US
Practice Address - Phone:570-278-3801
Practice Address - Fax:570-278-3648
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-11
Last Update Date:2015-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA136701282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01628205Medicaid
PA176655Medicare PIN
PA01628205Medicaid
PA391306Medicare PIN