Organization
JERSEY SHORE HOSPITAL FOUNDATION, INC
Active
Other names
Jersey Shore Medical Associates
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CAREY W. PLUMMER CEO (CEO)
(570) 398-3101
Entity
Organization
Contact information
Practice address
104 EAST CENTRAL AVENUE, AVIS, PA 17721
(570) 753-8620
(570) 753-5489
Mailing address
104 EAST CENTRAL AVENUE, PO BOX 430, AVIS, PA 17721
(570) 753-8620
(570) 753-5489
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
208600000X
Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1001557500008
—
PA
01
—
220807
FIRST PRIORITY HEALTH
PA
01
—
555630
BLUE CROSS BLUE SHIELD
PA
01
—
5938
AETNA
PA
01
—
C2CE
GEISINGER HEALTH PLAN
PA
01
—
CL3010
RAILROAD MEDICARE
PA
Enumeration date
12/15/2006
Last updated
04/03/2014
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