Organization
SCRANTON QUINCY CLINIC COMPANY LLC
Active
Other names
Physicians Health Alliance
Organization subpart
No
Provider details
NPI number
Authorized official
DEBBIE THORN BREWER (DIRECTOR)
(877) 892-9813
Entity
Organization
Contact information
Practice address
748 QUINCY AVE, SUITE 2A, SCRANTON, PA 18510-1739
(570) 961-0851
(570) 344-4285
Mailing address
PO BOX 689022, FRANKLIN, TN 37068-9022
(877) 309-5312
(615) 465-2877
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
207VG0400X
Gynecology Physician
—
—
363LF0000X
Family Nurse Practitioner
—
—
367A00000X
Advanced Practice Midwife
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102669377-0005
—
PA
Enumeration date
11/14/2011
Last updated
03/22/2012
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