NPIMap

Organization Active NPI

Divine Providence Hospital of the Sisters of Christian Charity

Doing business as Susquehanna Home Care & Hospice

  • Home Health Agency
  • Williamsport, PA
National Provider Identifier
1871548560
Registry record updated Jan 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
700605 Issued in PA
Legal business name
DIVINE PROVIDENCE HOSPITAL OF THE SISTERS OF CHRISTIAN CHARITY
Doing business as
Susquehanna Home Care & Hospice
Practice address
1100 Grampian Blvd
4 South
Williamsport, PA 17701-1909
Phone
(570) 320-7690
Fax
(570) 320-7692
NPI assigned
May 23, 2006
Last updated
Jan 2, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2012

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

Authorized official

Name
Ms. Patricia McGee, RN
Title
Administrative Director
Phone
(570) 320-7690

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 700605 PA Primary

Addresses

Primary practice location

1100 Grampian Blvd
4 South
Williamsport, PA 17701-1909

Mailing address

1100 Grampian Blvd
4 South
Williamsport, PA 17701-1909
Phone (570) 320-7690

Other identifiers 2

IdentifierTypeStateIssuer
1007563750023MedicaidPA
817415OtherPAFPH BILLING NUMBER

Other names 1

  • Susquehanna Home Care & Hospice Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory

Ownership & related parties

Change-of-ownership history 1

DateEventCounterparty
Aug 1, 2018 Change of OwnershipThis provider was the seller Upmc Home HealthcareCCN 397006, PA, NPI 1881189256

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

NPI Registry JSON

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325462400000",
    "number": "1871548560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 GRAMPIAN BLVD",
            "address_2": "4 SOUTH",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177011909",
            "telephone_number": "570-320-7690",
            "fax_number": "570-320-7692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 GRAMPIAN BLVD",
            "address_2": "4 SOUTH",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177011909",
            "telephone_number": "570-320-7690",
            "fax_number": "570-320-7692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE PROVIDENCE HOSPITAL OF THE SISTERS OF CHRISTIAN CHARITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-23",
        "last_updated": "2012-01-02",
        "status": "A",
        "authorized_official_last_name": "MCGEE",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "ADMINISTRATIVE DIRECTOR",
        "authorized_official_telephone_number": "570-320-7690",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "PA",
            "license": "700605",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007563750023",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FPH BILLING NUMBER",
            "identifier": "817415",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Susquehanna Home Care & Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Williamsport, PA

Sources for this page

Verify at the official NPI Registry.