Organization
JERSEY SHORE HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK A. O'NEILL (CFO)
(570) 398-3100
Entity
Organization
Contact information
Practice address
1020 THOMPSON ST, JERSEY SHORE, PA 17740-1729
(570) 398-0100
(570) 398-4412
Mailing address
1020 THOMPSON ST, JERSEY SHORE, PA 17740-1729
(570) 398-0100
(570) 398-4412
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
101401
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
009912
FIRST PRIORITY
PA
01
—
10011
GEISINGER
PA
05
—
1007703560018
—
PA
01
—
391300
BLUE CROSS
PA
01
—
5511
HEALTH AMERICA
PA
01
—
59746
AETNA
PA
Enumeration date
02/14/2007
Last updated
08/22/2020
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