# SCHUYLKILL MEDICAL CENTER - EAST NORWEGIAN STREET

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SCHUYLKILL MEDICAL CENTER - EAST NORWEGIAN STREET
- **Other names:** Good Samaritan Regional Medical Center
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1073710166
- **Legal business name:** SCHUYLKILL MEDICAL CENTER - EAST NORWEGIAN STREET
- **Authorized official:** JOHN E. SIMODEJKA (PRESIDENT & CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (717) 621-5111

## Contact information

- **Practice address:** 700 E NORWEGIAN ST, PHYSICAN BILLING, POTTSVILLE, PA 17901-2710
- **Practice address phone:** (570) 621-8646
- **Mailing address:** 700 E NORWEGIAN ST, PHYSICAN BILLING, POTTSVILLE, PA 17901-2710
- **Mailing address phone:** (570) 621-8646
- **Mailing address fax:** (570) 621-4316

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | — | PA | — |
| 363AS0400X | Surgical Physician Assistant | — | PA | Yes |
| 367500000X | Certified Registered Nurse Anesthetist | — | PA | — |

## Other

- **Enumeration date:** 07/02/2007
- **Last updated:** 10/16/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1783963 | HIGHMARK BS | PA |