# BLOOMSBURG PHYSICIANS SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457543290
- **Authorized official:** JOSEPH DEVITO (CFO)
- **Authorized official phone:** (570) 387-2148

## Contact information

- **Practice address:** 549 FAIR ST, BLOOMSBURG, PA 17815-1419
- **Practice address phone:** (570) 387-2100
- **Mailing address:** 549 FAIR ST, PO BOX 919, BLOOMSBURG, PA 17815-1419
- **Mailing address phone:** (570) 387-2100

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207QG0300X | Geriatric Medicine (Family Medicine) Physician | — | NULL | — |
| 207QG0300X | Geriatric Medicine (Family Medicine) Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | — |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | — |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 208600000X | Surgery Physician | — | NULL | — |
| 208600000X | Surgery Physician | — | — | — |

## Other

- **Enumeration date:** 08/15/2007
- **Last updated:** 08/15/2007