| Portland Medical Center, Pc | |
|
716 Delaware Avenue Portland PA 18351-0358 | |
| (570) 897-6272 | |
| Not Available |
| Full Name | Portland Medical Center, Pc |
|---|---|
| Speciality | Clinic/center |
| Location | 716 Delaware Avenue, Portland, Pennsylvania |
| Authorized Official Name and Position | Raymond Decesare (PRESIDENT) |
| Authorized Official Contact | 5708976272 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Portland Medical Center, Pc 716 Delaware Avenue Portland PA 18351-0358 Ph: (570) 897-6272 | Portland Medical Center, Pc 716 Delaware Avenue Portland PA 18351-0358 Ph: (570) 897-6272 |
| NPI Number | 1598886616 |
|---|---|
| Provider Enumeration Date | 04/03/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598886616 | NPI | - | NPPES |
| 548961 | Other | US HEALTHCARE | |
| DE 041920 | Other | PA BLUE SHIELD | |
| 14843 | Other | GEISENGERS HEALTH CARE | |
| 001706 | Other | PA | FIRST PRIORITY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | OS002690L (Pennsylvania) | Primary |