Organization
CLINTON HOSPITAL CORPORATION
Active
Other names
Haven Center for Women's Health
Organization subpart
No
Provider details
NPI number
Authorized official
TARA P RICHARDSON (AUTHORIZED OFFICIAL)
(615) 221-3672
Entity
Organization
Contact information
Practice address
24 CREE DR, LOCK HAVEN, PA 17745-2639
(570) 893-5043
(570) 893-5126
Mailing address
PO BOX 689022, FRANKLIN, TN 37068-9022
(570) 893-5043
(570) 893-5126
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
122201
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007550910020
—
PA
Enumeration date
03/07/2014
Last updated
04/27/2016
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