Jersey Shore Hospital Foundation, Inc

Organization Active NPI Family Medicine Physician · Avis, PA

NPI 1417019498 · NPPES record last updated Apr 3, 2014

Key facts

NPI
1417019498
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
JERSEY SHORE HOSPITAL FOUNDATION, INC
Practice address
104 East Central Avenue
Avis, PA 17721
Phone
(570) 753-8620
Fax
(570) 753-5489
NPI assigned
Dec 15, 2006
Organization subpart
No

Authorized official

Name
Mr. Carey W. Plummer, CEO
Title
Ceo
Phone
(570) 398-3101

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

529 High St
Ste 2
Lock Haven, PA 17745
Phone (570) 748-8034

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207Q00000X Yes
Internal Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207R00000X
Orthopaedic Surgery Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207X00000X
Surgery Physician
Group: 193200000X MULTI-SPECIALTY GROUP
208600000X

Addresses

Primary practice location

104 East Central Avenue
Avis, PA 17721

Mailing address

104 East Central Avenue
PO Box 430
Avis, PA 17721
Phone (570) 753-8620

Other identifiers

IdentifierTypeStateIssuer
CL3010OtherPARAILROAD MEDICARE
1001557500008MedicaidPA
220807OtherPAFIRST PRIORITY HEALTH
5938OtherPAAETNA
C2CEOtherPAGEISINGER HEALTH PLAN
555630OtherPABLUE CROSS BLUE SHIELD

Other names

  • Jersey Shore Medical Associates Doing business as

Other providers in Avis, PA

All providers in Avis, PA · Family Medicine Physician in Pennsylvania

Sources for this page

Verify at the official NPI Registry.