Organization
NORTH PENN COMPREHENSIVE HEALTH SERVICES
Active
Other names
Blossburg Laurel Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA M. VANZILE (CREDENTIALING COORDINATOR)
(570) 662-1982
Entity
Organization
Contact information
Practice address
6 RIVERSIDE PLZ, BLOSSBURG LAUREL HEALTH CENTER, BLOSSBURG, PA 16912-1137
(570) 638-2174
(570) 638-3006
Mailing address
6A RIVERSIDE PLZ, BLOSSBURG, PA 16912-1137
(570) 662-1945
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000011720035
—
PA
Enumeration date
10/19/2006
Last updated
06/08/2022
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