Provider Demographics
NPI:1982721155
Name:KEYSTONE SERVICE SYSTEMS, INC.
Entity type:Organization
Organization Name:KEYSTONE SERVICE SYSTEMS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHEIF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:J
Authorized Official - Last Name:HOOKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-232-7509
Mailing Address - Street 1:124 PINE ST
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17101-1208
Mailing Address - Country:US
Mailing Address - Phone:717-232-7509
Mailing Address - Fax:717-232-6687
Practice Address - Street 1:217 RACE ST
Practice Address - Street 2:
Practice Address - City:SUNBURY
Practice Address - State:PA
Practice Address - Zip Code:17801-1909
Practice Address - Country:US
Practice Address - Phone:717-232-7509
Practice Address - Fax:717-232-6687
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283X00000XHospitalsRehabilitation Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100001038 0375Medicaid