Lackawanna Medical Group Pc

LBN: Lackawanna Medical Group Pc
Lackawanna Medical Group Pc is an health care organization with primary practice located at 201 Smallacombe Dr , Scranton PA 18508-2616. The organization recently has 8 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Gastroenterology, Allopathic & Osteopathic Physicians / Nuclear Cardiology, Allopathic & Osteopathic Physicians / Pediatrics, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Family. Allopathic & Osteopathic Physicians / Internal Medicine is the primary health care specialty. Lackawanna Medical Group Pc can be contacted via phone (570) 961-0171, or through Grad, Charles Thomas via phone (570) 348-1130.

Contact Information

Primary practice address
201 Smallacombe Dr Scranton PA 18508-2616
Phone: (570) 961-0171
Fax: (570) 207-2411
Website:
Map and Directions
Authorized official contact:
Name: Grad, Charles Thomas
Phone: (570) 348-1130

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X
Allopathic & Osteopathic Physicians / Nuclear Cardiology 207UN0901X
Allopathic & Osteopathic Physicians / Pediatrics 208000000X
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X

Profile Details

NPI number 1770650962
LBN Legal business name Lackawanna Medical Group Pc
DBA Doing business as
Authorized official Grad, Charles Thomas
Entity Organization
Organization subpart 1 No
Enumeration date Nov 30th, 2006
Last updated Mar 3rd, 2016 - about 8 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770650962 NPPES
Pennsylvania MEDICAID 000676727

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