| Black Creek Health Center | |
|
75 Pineapple Street Nuremberg PA 18241-0670 | |
| (570) 704-4235 | |
| (570) 384-3454 |
| Full Name | Black Creek Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 75 Pineapple Street, Nuremberg, Pennsylvania |
| Authorized Official Name and Position | Edward Mccarthy (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 5708258741 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Black Creek Health Center 1084 Route 315 Wilkes-barre PA 18702-7012 Ph: (570) 825-8741 | Black Creek Health Center 75 Pineapple Street Nuremberg PA 18241-0670 Ph: (570) 704-4235 |
| NPI Number | 1871695148 |
|---|---|
| Provider Enumeration Date | 09/05/2006 |
| Last Update Date | 03/06/2020 |
| Medicare PECOS PAC ID | 1052362662 |
|---|---|
| Medicare Enrollment ID | O20100902000237 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871695148 | NPI | - | NPPES |
| 1007296090014 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |