Organization
UPMC WILLIAMSPORT
Active
Other names
Williamsport Regional Medical Center SPU- Divine Providence Campus
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER STOCKHAUSEN (CFO)
(412) 578-9592
Entity
Organization
Contact information
Practice address
1100 GRAMPIAN BLVD, WILLIAMSPORT, PA 17701-1909
(570) 326-8000
Mailing address
600 GRANT ST, US STEEL TOWER, 59TH FLOOR, C/O RENEE JOHNSON, PITTSBURGH, PA 15219-2740
(412) 623-6303
(412) 623-6369
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007548350043
—
PA
Enumeration date
12/21/2018
Last updated
11/27/2023
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