| Mansfield Laurel Health Center | |
|
416 S Main St Mansfield Laurel Health Center Mansfield PA 16933-1510 | |
| (570) 662-2002 | |
| (570) 662-2025 |
| Full Name | Mansfield Laurel Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 416 S Main St, Mansfield, Pennsylvania |
| Authorized Official Name and Position | Angela M. Vanzile (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 5706621945 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mansfield Laurel Health Center 6a Riverside Plz Blossburg PA 16912-1137 Ph: (570) 662-1945 | Mansfield Laurel Health Center 416 S Main St Mansfield Laurel Health Center Mansfield PA 16933-1510 Ph: (570) 662-2002 |
| NPI Number | 1750461455 |
|---|---|
| Provider Enumeration Date | 10/17/2006 |
| Last Update Date | 06/08/2022 |
| Medicare PECOS PAC ID | 0446245880 |
|---|---|
| Medicare Enrollment ID | O20050512000305 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750461455 | NPI | - | NPPES |
| 1000011720038 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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