Organization
DIVINE PROVIDENCE HOSPITAL OF THE SISTERS OF CHRISTIAN CHARITY
Active
Other names
Divine Providence Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ERIC D. POHJALA FHFMA, FACHE (EXECUTIVE VICE PRESIDENT CFO, CPO)
(570) 321-3171
Entity
Organization
Contact information
Practice address
1100 GRAMPIAN BLVD, WILLIAMSPORT, PA 17701-1909
(570) 326-8000
(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
261QA1903X
Ambulatory Surgical Clinic/Center
041001
PA
261QR0206X
Mammography Clinic/Center
041001
PA
282N00000X
General Acute Care Hospital
041001
PA
283Q00000X
Psychiatric Hospital
Primary
041001
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000070
AMERIHEALTH ADMINST PIN
PA
05
—
1007563750008
—
PA
01
—
1066310
KEYSTONE MERCY HEALTH PIN
PA
01
—
20012697
AMERIHEALTH HMO AMER PIN
PA
01
—
394048
HEALTH ASSURANCE PIN
PA
01
—
396871
BLACK LUNG PROGRAM PIN
PA
01
—
70159
GEISINGER HEALTH PLAN PIN
PA
01
—
816867
FIRST PRIORITY HEALTH PIN
PA
Enumeration date
07/11/2006
Last updated
07/25/2016
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