# SCHUYLKILL MEDICAL CENTER - EAST NORWEGIAN STREET

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Schuylkill Medical Center - East Norwegian Street Physician Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518273572
- **Authorized official:** MR. JOHN E SIMODEJKA (PRESIDENT & CHIEF EXEC. OFFICER)
- **Authorized official phone:** (570) 621-5111

## Contact information

- **Practice address:** 700 E NORWEGIAN ST, POTTSVILLE, PA 17901-2710
- **Practice address phone:** (570) 621-4143
- **Practice address fax:** (570) 621-4769
- **Mailing address:** 700 E NORWEGIAN ST, POTTSVILLE, PA 17901-2710
- **Mailing address phone:** (570) 621-4143
- **Mailing address fax:** (570) 621-4769

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | NULL | Yes |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/27/2010
- **Last updated:** 08/27/2010