Organization
LEHIGH VALLEY HOSPITAL - SCHUYLKILL
Active
Other names
Schuylkill Medical Center - South Jackson Street CRNA Group
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS MARCHOZZI (EVP &CFO)
(484) 862-3943
Entity
Organization
Contact information
Practice address
420 S JACKSON ST, POTTSVILLE, PA 17901-3625
(570) 621-5000
(570) 622-8221
Mailing address
420 S JACKSON ST, POTTSVILLE, PA 17901-3625
(570) 621-5000
(570) 622-8221
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
421001
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1373786
BLUE SHIELD - ANESTHESIA
PA
Enumeration date
08/10/2005
Last updated
06/27/2019
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