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431 Hepburn St Williamsport PA 17701-6122 | |
(570) 567-5400 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 431 Hepburn St, Williamsport, Pennsylvania |
Authorized Official Name and Position | Max Houseknecht (CHIEF FINANCIAL OFFICER) |
Authorized Official Contact | 5705675418 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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471 Hepburn St Williamsport PA 17701-6122 Ph: (570) 567-5400 | 431 Hepburn St Williamsport PA 17701-6122 Ph: (570) 567-5400 |
NPI Number | 1790333292 |
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Provider Enumeration Date | 08/28/2019 |
Last Update Date | 09/24/2024 |
Medicare PECOS PAC ID | 8527251230 |
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Medicare Enrollment ID | O20191023002153 |
Identifier | Type | State | Issuer |
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1790333292 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Geisinger-hm Joint Venture, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1824 E 3rd St, Williamsport, PA 17701 Phone: 570-601-2200 Fax: 570-601-2202 | |
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