Organization
PATIENT CARE CORPORATION
Active
Other names
Patient Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES WILLIAM WASSEROTT IV (PRESIDENT CEO)
(570) 283-0691
Entity
Organization
Contact information
Practice address
515 517 MARKET STREET, KINGSTON, PA 18704-4535
(570) 283-0691
(570) 283-4836
Mailing address
515 517 MARKET STREET, KINGSTON, PA 18704-4535
(570) 283-0691
(570) 283-4836
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0005693700001
—
PA
01
—
282122
BLUE CROSS BLUE SHIELD
PA
01
—
P025384
TRICARE
PA
Enumeration date
12/04/2006
Last updated
08/22/2020
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