Organization · Type 2 NPI

Rural Health Corporation of Northeastern Pennsylvania

Federally Qualified Health Center (FQHC) · Edwardsville, PA

NPI number 1477655744 Active

Practice location

75 S Wyoming Ave Ste 2&3
Edwardsville, PA 18704-3103

Call (570) 704-4233 Map

Fax (570) 763-4489

Mailing address

276 E End Ctr
Wilkes Barre, PA 18702-6970

Specialties and licenses

Taxonomy	Code	License
Pediatrics Physician	208000000X	None listed
Federally Qualified Health Center (FQHC) Primary	261QF0400X	None listed
Medical Specialty Clinic/Center	261QM2500X	None listed

Federally Qualified Health Center (FQHC): Definition to come...

NPI record

NPI: 1477655744
Entity type: Organization (Type 2)
Issued: Sep 5, 2006
Last updated: Oct 26, 2023
Status: Active
Subpart: Yes of Rural Health Corporation of Northeastern Pennsylvania

Other names

<unavail>
Valley Medical · doing business as

Authorized official

Matthew J Iskra, MBA
CFO
(570) 825-8741

Verify this record

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.

Is this your record? How to update it.

About NPI 1477655744

Rural Health Corporation of Northeastern Pennsylvania's National Provider Identifier is 1477655744, issued on Sep 5, 2006. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in Edwardsville, PA. The record was last updated on Oct 26, 2023.