Provider Type Icon

RURAL HEALTH CORPORATION OF NORTHEASTERN PENNSYLVANIA NPI 1205938578


NPI Information

NPI: 1205938578
Provider Name: RURAL HEALTH CORPORATION OF NORTHEASTERN PENNSYLVANIA

Doing Business As: RURAL HEALTH CORPORATION OF NORTHEASTERN PENNSYLVANIA

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

CLIA Number: 39D0192693

Address:
2795 SULLIVANS TRL
FALLS, PA
ZIP 18615
Phone: (570) 704-4117
Get Directions

RURAL HEALTH CORPORATION OF NORTHEASTERN PENNSYLVANIA is a federally qualified health center (fqhc) clinic center in Falls, PA. RURAL HEALTH CORPORATION OF NORTHEASTERN PENNSYLVANIA NPI is 1205938578. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Rural Health Corporation Of Northeastern Pennsylvania.

The provider's business location address is:

2795 SULLIVANS TRL
FALLS, PA
ZIP 18615-949
Phone: (570) 704-4117
Fax: (570) 388-2046

The provider's authorized official is Matthew J Iskra .
The authorized official title is Chief Financial Officer and has the following contact phone number (570) 825-8741.

The CLIA number assigned to this NPI record is 39D0192693 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/5/2006 and was last updated on 1/25/2024.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineNo
2261QF0400XClinic/CenterFederally Qualified Health Center (FQHC)Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11007296090015MEDICAIDPENNSYLVANIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.