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Organization
BLOOMSBURG PHYSICIANS SERVICES
Active
Organization
BLOOMSBURG PHYSICIANS SERVICES
Active
Other names
BPS BENTON FAMILY PRACTICE
Organization subpart
No
Provider details
NPI number
Authorized official
MR. REGIS CABONOR (CEO)
(570) 387-2100
Entity
Organization
Contact information
Practice address
4469 RED ROCK RD, BENTON, PA 17814-7606
(570) 925-6424
Mailing address
PO BOX 919, BLOOMSBURG, PA 17815-0919
(570) 387-2100
(570) 387-2327
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001811559
—
PA
Enumeration date
09/09/2009
Last updated
09/09/2009
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