Organization
LAFAYETTE COLLEGE
Active
Other names
BAILEY HEALTH CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
DIRENDIA SHACKELFORD (MANAGED CARE SPECIALIST)
(800) 654-0889
Entity
Organization
Contact information
Practice address
607 HIGH ST, EASTON, PA 18042-7641
(610) 330-5001
(610) 330-5704
Mailing address
607 HIGH ST, EASTON, PA 18042-7641
(610) 330-5001
(610) 330-5704
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
MD045009E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3974741
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
10/23/2006
Last updated
10/09/2008
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