NPIMap

Organization Active NPI

Carbon Schuylkill Community Hospital

Doing business as St. Luke's Miners Memorial Hospital

  • Ambulatory Surgical Clinic/Center
  • Coaldale, PA
National Provider Identifier
1083746994
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
036801 Issued in PA
Legal business name
CARBON SCHUYLKILL COMMUNITY HOSPITAL
Doing business as
St. Luke's Miners Memorial Hospital
Practice address
360 W Ruddle St
Coaldale, PA 18218-1027
Phone
(570) 645-2131
NPI assigned
Mar 9, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Andrea T Rosko
Title
Executive Director, Slpho
Phone
(610) 954-4132

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 036801 PA Primary

Addresses

Primary practice location

360 W Ruddle St
Coaldale, PA 18218-1027

Mailing address

360 W Ruddle St
Coaldale, PA 18218-1027
Phone (570) 645-2131

Other identifiers 1

IdentifierTypeStateIssuer
1007454700014MedicaidPA

Other names 1

  • St. Luke's Miners Memorial Hospital Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Francis J Schell7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1083746994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 W RUDDLE ST",
            "city": "COALDALE",
            "state": "PA",
            "postal_code": "182181027",
            "telephone_number": "570-645-2131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 W RUDDLE ST",
            "city": "COALDALE",
            "state": "PA",
            "postal_code": "182181027",
            "telephone_number": "570-645-2131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARBON SCHUYLKILL COMMUNITY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROSKO",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR, SLPHO",
        "authorized_official_telephone_number": "610-954-4132",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "PA",
            "license": "036801",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007454700014",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Luke's Miners Memorial Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Coaldale, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.