| Laporte Medical Center | |
|
217 King Street Laporte PA 18626-0157 | |
| (570) 946-5201 | |
| Not Available |
| Full Name | Laporte Medical Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 217 King Street, Laporte, Pennsylvania |
| Authorized Official Name and Position | Matthew J Iskra (CFO) |
| Authorized Official Contact | 5708258741 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Laporte Medical Center 276 E End Ctr Wilkes Barre PA 18702-6970 Ph: (570) 946-5201 | Laporte Medical Center 217 King Street Laporte PA 18626-0157 Ph: (570) 946-5201 |
| NPI Number | 1225781602 |
|---|---|
| Provider Enumeration Date | 01/27/2022 |
| Last Update Date | 10/26/2023 |
| Medicare PECOS PAC ID | 1052362662 |
|---|---|
| Medicare Enrollment ID | O20220418001055 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225781602 | NPI | - | NPPES |
| 731976 | Other | PA | MEDICARE PTAN |
| ========= | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Mental Health Associates Of North Central Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: Main And King Street, Laporte, PA 18626 Phone: 570-265-2525 Fax: 570-265-1075 |