Organization
GOOD SHEPHERD CORPORATION
Active
Organization
GOOD SHEPHERD CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN ANTOGNOLI (CHIEF EXECUTIVE OFFICER)
(570) 702-8360
Entity
Organization
Contact information
Practice address
1327 WYOMING AVE, SCRANTON, PA 18509-2861
(570) 702-8360
(570) 702-8623
Mailing address
1327 WYOMING AVE, SCRANTON, PA 18509-2861
(570) 702-8360
(570) 702-8623
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
XRC970900
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007283070005
—
PA
Enumeration date
04/17/2007
Last updated
01/24/2011
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