Organization · Type 2 NPI

Gaudenzia Inc

Clinic/Center · Pottsville, PA

NPI number 1104058338 Active

Practice location

1 S 2nd St, 4th Floor
Pottsville, PA 17901-3174

Call (570) 622-6485 Map

Fax (570) 622-2422

Mailing address

106 W Main St
Norristown, PA 19401-4716

Specialties and licenses

Taxonomy	Code	License
Clinic/Center Primary	261Q00000X	547027 (PA)

Clinic/Center: A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

2 other providers at this address

Other clinic/center providers in Pottsville

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NPI record

NPI: 1104058338
Entity type: Organization (Type 2)
Issued: Aug 21, 2009
Last updated: Feb 24, 2022
Status: Active

Other names

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Gaudenzia Pottsville Outpatient · other name
Gaudenzia Pottsville Outpatient · other name

Authorized official

Mike Williams
Sr. Contracting Manager
(484) 338-3731

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1104058338

Gaudenzia Inc's National Provider Identifier is 1104058338, issued on Aug 21, 2009. The primary taxonomy on file is Clinic/Center (261Q00000X), and the practice location is in Pottsville, PA. The record was last updated on Feb 24, 2022.