Organization
TIOGA HEALTH CARE PROVIDERS, INC. 5
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD M GILBERT JR. (CHIEF FINANCIAL OFFICER)
(570) 723-0603
Entity
Organization
Contact information
Practice address
32-36 CENTRAL AVE, WELLSBORO, PA 16901-1840
(570) 723-0140
(570) 724-6541
Mailing address
32-36 CENTRAL AVE, WELLSBORO, PA 16901-1840
(570) 723-0140
(570) 724-6541
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018612000004
—
PA
01
—
919529
BLUE CROSS/BLUE SHIELD
PA
Enumeration date
08/03/2006
Last updated
08/22/2020
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