Organization
GUTHRIE MEDICAL GROUP PC
Active
Other names
Guthrie Clinic Lab
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH A. SCOPELLITI MD (PRESIDENT)
(570) 888-5858
Entity
Organization
Contact information
Practice address
1 GUTHRIE SQ, SAYRE, PA 18840-1625
(570) 888-5858
Mailing address
1 GUTHRIE SQ, SAYRE, PA 18840-1625
(570) 888-5858
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
000654
PA
291U00000X
Clinical Medical Laboratory
Primary
39D0193451
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00371664
—
NY
05
—
1007332090003
—
PA
01
—
398221
MEDICARE GROUP ID
PA
01
—
CC9269
RR MEDICARE GROUP
PA
Enumeration date
05/24/2006
Last updated
02/22/2016
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