Provider Demographics
NPI:1386934420
Name:TUNKHANNOCK HOSPITAL COMPANY LLC
Entity type:Organization
Organization Name:TUNKHANNOCK 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:
Authorized Official - Last Name:LALOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:629-215-3953
Mailing Address - Street 1:880 SR 6 W
Mailing Address - Street 2:
Mailing Address - City:TUNKHANNOCK
Mailing Address - State:PA
Mailing Address - Zip Code:18657-6149
Mailing Address - Country:US
Mailing Address - Phone:570-836-6236
Mailing Address - Fax:570-836-7057
Practice Address - Street 1:5950 SR 6
Practice Address - Street 2:
Practice Address - City:TUNKHANNOCK
Practice Address - State:PA
Practice Address - Zip Code:18657-7905
Practice Address - Country:US
Practice Address - Phone:570-836-6236
Practice Address - Fax:570-836-7057
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TUNKHANNOCK HOSPITAL COMPANY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-04-11
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
39U192Medicare Oscar/Certification