Organization
FAMILY HEALTH CLINIC INC
Active
Other names
Susquehanna Family Health Clinic Inc
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WARREN S DEWITT MD (OWNER)
(570) 853-3995
Entity
Organization
Contact information
Practice address
401 BROAD AVE, SUSQUEHANNA, PA 18847-1611
(570) 853-3995
(570) 853-3728
Mailing address
PO BOX 11, SUSQUEHANNA, PA 18847-0011
(570) 853-3995
(570) 853-3728
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
MD024723E
PA
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0011996300001
—
PA
Enumeration date
07/15/2006
Last updated
01/28/2021
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