Provider Demographics
NPI:1336960533
Name:NORTHEASTERN PENNSYLVANIA HEALTH CORPORATION
Entity type:Organization
Organization Name:NORTHEASTERN PENNSYLVANIA HEALTH CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LENICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-402-1968
Mailing Address - Street 1:101 EAST ST
Mailing Address - Street 2:
Mailing Address - City:HAZLETON
Mailing Address - State:PA
Mailing Address - Zip Code:18201-7407
Mailing Address - Country:US
Mailing Address - Phone:570-501-4850
Mailing Address - Fax:570-501-4851
Practice Address - Street 1:101 EAST ST
Practice Address - Street 2:
Practice Address - City:HAZLETON
Practice Address - State:PA
Practice Address - Zip Code:18201-7407
Practice Address - Country:US
Practice Address - Phone:570-501-4850
Practice Address - Fax:570-501-4851
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTHEASTERN PENNSYLVANIA HEALTH CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-10-21
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy