Organization
SUSQUEHANNA VENTURES, INC.
Active
Organization
SUSQUEHANNA VENTURES, INC.
Active
Other names
Susquehanna Home Medical PO
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES SANTANGELO (CFO)
(570) 320-7661
Entity
Organization
Contact information
Practice address
1201 GRAMPIAN BLVD, SUSQUEHANNA HOME MEDICAL PO, WILLIAMSPORT, PA 17701-1900
(570) 320-7660
(570) 320-7659
Mailing address
1201 GRAMPIAN BLVD, SUSQUEHANNA HOME MEDICAL PO, WILLIAMSPORT, PA 17701-1900
(570) 320-7660
(570) 320-7659
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
PP413352L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007515570011
—
PA
01
—
815788
BLUE CROSS FPH
PA
Enumeration date
03/05/2007
Last updated
08/22/2020
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