| Blossburg Laurel Health Center | |
|
6 Riverside Plz Blossburg Laurel Health Center Blossburg PA 16912-1137 | |
| (570) 638-2174 | |
| (570) 638-3006 |
| Full Name | Blossburg Laurel Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 6 Riverside Plz, Blossburg, Pennsylvania |
| Authorized Official Name and Position | Angela M. Vanzile (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 5706621982 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Blossburg Laurel Health Center 6a Riverside Plz Blossburg PA 16912-1137 Ph: (570) 662-1945 | Blossburg Laurel Health Center 6 Riverside Plz Blossburg Laurel Health Center Blossburg PA 16912-1137 Ph: (570) 638-2174 |
| NPI Number | 1154403038 |
|---|---|
| Provider Enumeration Date | 10/19/2006 |
| Last Update Date | 06/08/2022 |
| Medicare PECOS PAC ID | 0446245880 |
|---|---|
| Medicare Enrollment ID | O20050512000222 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154403038 | NPI | - | NPPES |
| 1000011720035 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Ollock Dental Group Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 116 Seymour St, Blossburg, PA 16912 Phone: 570-638-3468 | |
North Penn Comprehensive Health Services Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 116 Seymour St, Blossburg, PA 16912 Phone: 570-638-3468 |