Provider Demographics
NPI:1285883553
Name:CARBON - SCHUYLKILL COMMUNITY HOSPITAL INC
Entity type:Organization
Organization Name:CARBON - SCHUYLKILL COMMUNITY HOSPITAL INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SR VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:LICHTENWALNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-954-3301
Mailing Address - Street 1:801 OSTRUM ST
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18015-1000
Mailing Address - Country:US
Mailing Address - Phone:610-954-6048
Mailing Address - Fax:610-954-6500
Practice Address - Street 1:34 S RAILROAD ST
Practice Address - Street 2:
Practice Address - City:TAMAQUA
Practice Address - State:PA
Practice Address - Zip Code:18252
Practice Address - Country:US
Practice Address - Phone:484-526-4766
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-11
Last Update Date:2019-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA178775Medicare PIN