Provider Demographics
NPI:1316919699
Name:BERWICK HOSPITAL COMPANY LLC
Entity type:Organization
Organization Name:BERWICK HOSPITAL COMPANY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/DELEGATED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:M
Authorized Official - Last Name:LALOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-925-4565
Mailing Address - Street 1:701 E 16TH ST
Mailing Address - Street 2:
Mailing Address - City:BERWICK
Mailing Address - State:PA
Mailing Address - Zip Code:18603-2316
Mailing Address - Country:US
Mailing Address - Phone:570-759-5000
Mailing Address - Fax:570-759-3473
Practice Address - Street 1:701 E 16TH ST
Practice Address - Street 2:
Practice Address - City:BERWICK
Practice Address - State:PA
Practice Address - Zip Code:18603-2316
Practice Address - Country:US
Practice Address - Phone:570-759-5000
Practice Address - Fax:570-759-3473
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-02
Last Update Date:2017-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA024901282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
009605OtherFIRST PRIORITY HEALTH
390072OtherBCBS
0009605OtherAETNA
1583OtherHIGHMARK
20352OtherGHP
PA1007562590006Medicaid
039666600OtherBLACK LUNG
PA1007562590003Medicaid
1503308OtherGATEWAY
1503308OtherGATEWAY