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Organization
JERSEY SHORE HOSPITAL FOUNDATION, INC
Active
Organization
JERSEY SHORE HOSPITAL FOUNDATION, INC
Active
Other names
Jersey Shore Medical Associates
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CAREY W. PLUMMER CEO (CEO)
(570) 398-3101
Entity
Organization
Contact information
Practice address
104 EAST CENTRAL AVENUE, AVIS, PA 17721
(570) 753-8620
(570) 753-5489
Mailing address
104 EAST CENTRAL AVENUE, PO BOX 430, AVIS, PA 17721
(570) 753-8620
(570) 753-5489
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
NULL
207X00000X
Orthopaedic Surgery Physician
—
—
208600000X
Surgery Physician
—
NULL
208600000X
Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1001557500008
—
PA
01
—
220807
FIRST PRIORITY HEALTH
PA
01
—
555630
BLUE CROSS BLUE SHIELD
PA
01
—
5938
AETNA
PA
01
—
C2CE
GEISINGER HEALTH PLAN
PA
01
—
CL3010
RAILROAD MEDICARE
PA
Enumeration date
12/15/2006
Last updated
04/03/2014
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