| Gaudenzia Inc | |
|
51 S 4th St Sunbury PA 17801-2730 | |
| (570) 988-1901 | |
| (570) 988-2868 |
| Full Name | Gaudenzia Inc |
|---|---|
| Speciality | Clinic/center |
| Location | 51 S 4th St, Sunbury, Pennsylvania |
| Authorized Official Name and Position | Mike Williams (SENIOR CONTRACTING MANAGER) |
| Authorized Official Contact | 4843383731 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gaudenzia Inc 106 W Main St Norristown PA 19401-4716 Ph: (610) 239-9600 | Gaudenzia Inc 51 S 4th St Sunbury PA 17801-2730 Ph: (570) 988-1901 |
| NPI Number | 1023133295 |
|---|---|
| Provider Enumeration Date | 03/20/2007 |
| Last Update Date | 01/18/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023133295 | NPI | - | NPPES |
| 1002285890009 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 497023 (Pennsylvania) | Primary |
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