RURAL HEALTH CORPORATION OF NORTHEASTERN PENNSYLVANIA (NPI# 1871695148) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871695148 |
| Entity Type | Organization |
| Organization Name | RURAL HEALTH CORPORATION OF NORTHEASTERN PENNSYLVANIA |
| Other Organization Name | BLACK CREEK HEALTH CENTER |
| Practice Address |
75 Pineapple Street Nuremberg PA 18241-0670 |
| Mailing Address |
1084 Route 315 Wilkes-barre PA 18702-7012 |
| Practice Telephone | 5707044235 |
| Practice Fax Number | 5703843454 |
| Mailing Telephone | 5708258741 |
| Mailing Fax Number | 5708258990 |
| Enumeration Date | 2006-09-05 |
| Last Update Date | 2020-03-06 |
| Authorized Official Name | EDWARD MCCARTHY (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 5708258741 |
| Is Organization Subpart | Y |
| Parent Organization Name | RURAL HEALTH CORPORATION OF NORTHEASTERN PENNSYLVANIA |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 1007296090014 | 05 |
| Other Name | Type Code |
|---|---|
| BLACK CREEK HEALTH CENTER | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679115760 | Rural Health Corporation of Northeastern Pennsylvania | Pediatrics | 1730 E Broad St Ste 2, Hazleton, PA 18201-5657 | 2019-10-10 |
| 1265801112 | Rural Health Corporation of Northeastern Pennsylvania | Clinic/Center | 39 E Jackson St, Wilkes Barre, PA 18701-2709 | 2015-09-22 |
| 1437351640 | Rural Health Corporation of Northeastern Pennsylvania | Dentist | 1084 Route 315, Wilkes-barre, PA 18702-7012 | 2007-06-01 |
| 1790887057 | Rural Health Corporation of Northeastern Pennsylvania | Family Medicine | 26 N Main St, Shickshinny, PA 18655-1302 | 2006-09-05 |
| 1629170980 | Rural Health Corporation of Northeastern Pennsylvania | Family Medicine | 2888 Sr 29 S, Monroe Township, PA 18636-7854 | 2006-09-05 |
| 1205938578 | Rural Health Corporation of Northeastern Pennsylvania | Family Medicine | 2795 Sullivans Trl, Falls, PA 18615-7949 | 2006-09-05 |
| 1477655744 | Rural Health Corporation of Northeastern Pennsylvania | Pediatrics | 75 S Wyoming Ave Ste 2&3, Edwardsville, PA 18704-3103 | 2006-09-05 |
| 1336241694 | Rural Health Corporation of Northeastern Pennsylvania | Family Medicine | 404 Ridge St, Freeland, PA 18224-1805 | 2006-09-05 |
| Street Address |
75 PINEAPPLE STREET |
| City | NUREMBERG |
| State | PA |
| Zip Code | 18241-0670 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356461479 | Tracey Hopeck | Dental Hygienist | 75 Pineapple Street, Black Creek Health Center, Nuremberg, PA 18241-0670 | 2007-03-30 |
| 1386723534 | Diane Petrovich | Physician Assistant | 75 Pineapple Street, Black Creek Health Center, Nuremberg, PA 18241-0670 | 2006-11-06 |
| 1154404291 | George D Yurko | Family Medicine | 75 Pineapple Street, Black Creek Health Center, Nuremberg, PA 18241-0670 | 2006-10-23 |
| 1316037708 | Robert E Astleford | Dentist | 75 Pineapple Street, Black Creek Health Center, Nuremberg, PA 18241-0670 | 2006-10-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235138108 | Nuremberg Community Ambulance Association | Ambulance | Hazle St, Nuremberg, PA 18241 | 2005-07-21 |
| 1396865283 | Patricia Lavan | Dental Hygienist | Black Creek Health Center, 75 Pineapple Street, Nuremberg, PA 18241-0670 | 2007-04-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932488780 | Elizabeth Ann Kuegeler Wolters | Speech-Language Pathologist | Adelgundenstrasse 31, Nuremberg, BAVARIA 90419 | 2011-08-11 |
| 1235138108 | Nuremberg Community Ambulance Association | Ambulance | Hazle St, Nuremberg, PA 18241 | 2005-07-21 |
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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| 1538781166 | Hyndman Area Health Center, Inc. | Clinic/Center | 214 College Park Plz Ste 203, Johnstown, PA 15904-2833 | 2020-05-18 |
| 1588285076 | Community Health and Dental Care, Inc | Clinic/Center | 1315 Route 100 North, Barto, PA 19504-8724 | 2020-05-06 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.