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205 Chestnut St Suite 2 Berwick PA 18603-3817 | |
| (570) 752-2985 | |
| (570) 752-2987 |
| Full Name | |
|---|---|
| Speciality | Clinic/center |
| Location | 205 Chestnut St, Berwick, Pennsylvania |
| Authorized Official Name and Position | Michael Coyle (DIR. FISCAL & ACCOUNTING OPERATION) |
| Authorized Official Contact | 6102399600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
106 W Main St Norristown PA 19401-4716 Ph: (610) 239-9600 | 205 Chestnut St Suite 2 Berwick PA 18603-3817 Ph: (570) 752-2985 |
| NPI Number | 1407193972 |
|---|---|
| Provider Enumeration Date | 01/03/2013 |
| Last Update Date | 01/03/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407193972 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 197056 (Pennsylvania) | Primary |
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