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DSH390270AQ GEISINGER WYOMING VALLEY MED CTR (Active)
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Main Details
Name
GEISINGER WYOMING VALLEY MED CTR
Subdivision Name
General Diagnostic Radiology 1000 E Mountain Dr - General Diagnostic Radiology
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH390270AQ
Medicare Provider Number
390270
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/3/2018
Participating Start Date
10/1/2018
Participating Approval Date
8/3/2018
Last Recertification Date
8/27/2024
Contacts
Authorizing Official
Geisinger Wyoming Valley Medical Center
Ron Beer, Chief Admiistrative Officer
(570) 808-5380
Primary Contact
Geisinger Health
Lola Travelpiece, 340B Program Manager
(570) 214-1035
Addresses
Street Address
1000 East Mountain Blvd
Wilkes Barre, PA 18711
Billing Address
Geisinger Wyoming Valley Medical Center
1000 East Mountain Blvd
Wilkes Barre, PA 18711
Comments
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