Organization
SCHUYLKILL COUNTY AVTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GERALD ACHENBACH (EXECUTIVE DIRECTOR)
57054409131
Entity
Organization
Contact information
Practice address
17 MAPLE AVE, MARLIN, PA 17951-0130
(570) 544-9131
(570) 544-6412
Mailing address
17 MAPLE AVE, PO BOX 130, MARLIN, PA 17951-0130
(570) 544-9131
(570) 544-6412
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1019607110001
—
PA
Enumeration date
12/17/2007
Last updated
12/17/2007
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