Organization
UPMC WILLIAMSPORT
Active
Other names
The Williamsport Hospital & Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES J SANTANGELO CPA FHFMA (EXECUTIVE VP CFO)
(570) 321-3171
Entity
Organization
Contact information
Practice address
777 RURAL AVE, WILLIAMSPORT, PA 17701-3109
(570) 321-1000
(570) 326-8601
Mailing address
1205 GRAMPIAN BLVD, 2ND FLOOR, WILLIAMSPORT, PA 17701-1978
(570) 326-8676
(570) 326-8601
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
234601
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000109
AMERIHEALTH ADMINST PIN
PA
01
—
074006
FIRST PRIORITY HEALTH PIN
PA
05
—
1007548350010
—
PA
01
—
1017347
KEYSTONE MERCY HEALTH PIN
PA
01
—
20007166
AMERIHEALTH HMO AMER PIN
PA
01
—
29796
GEISINGER HEALTH PLAN PIN
PA
01
—
301400
BLACK LUNG PROGRAM PIN
PA
01
—
390045
AETNA PIN
PA
Enumeration date
10/26/2006
Last updated
02/27/2020
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