Organization
MID VALLEY HOSPITAL ASSOC
Active
Other names
MID VALLEY HOSPITAL ANESTHESIOLOGY
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES BRITTAIN (CFO)
(570) 340-2991
Entity
Organization
Contact information
Practice address
1400 MAIN ST, PECKVILLE, PA 18452-2009
(570) 383-5500
Mailing address
400 E 10TH ST, WACONIA, MN 55387-4552
(952) 442-9770
(952) 442-3621
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000390109
BLUE CROSS OF PA
PA
Enumeration date
07/26/2006
Last updated
03/11/2009
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