Embassy Loyalsock, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

EMBASSY LOYALSOCK, LLC

Practice address

1445 Sycamore Rd
Montoursville, PA 17754-9519

Phone

(570) 601-8100

NPI assigned

Sep 28, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

George Repchick

Title

President of Manager

Phone

(216) 378-2050

Specialties & licenses 1

Addresses

Other names 1

• Embassy of Loyalsock Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1601251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601251200000",
    "number": "1013524651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25201 CHAGRIN BLVD",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1445 SYCAMORE RD",
            "city": "MONTOURSVILLE",
            "state": "PA",
            "postal_code": "177549519",
            "telephone_number": "570-601-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMBASSY LOYALSOCK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-28",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-28",
        "status": "A",
        "authorized_official_last_name": "REPCHICK",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "PRESIDENT OF MANAGER",
        "authorized_official_telephone_number": "216-378-2050"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Embassy of Loyalsock",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Lauren Elizabeth Fabian, PA-C
• Jenna Marie Farquhar, MD

• Skilled Nursing Facility in Montoursville, PA
• Providers in Montoursville, PA by specialty
• Skilled Nursing Facility in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.