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Contact Information

BACK MOUNTAIN PEDIATRICS
550 MEMORIAL HIGHWAY
DALLAS, PA18612
 Phone: 570-675-7955
 Fax: 570-675-7882
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

208000000X 37 Physician/Pediatric Medicine
 

Clinical Medical Laboratory

291U00000X 69 Clinical Laboratory
Indicates primary specialty

NPI Profile & details for BACK MOUNTAIN PEDIATRICS

NPI Number 1063621233
LBN Legal business name BACK MOUNTAIN PEDIATRICS
Authorized official JOAN GREULICK - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 05/22/2007
Last updated 09/11/2025 - About 9 months ago
Identifiers
PA License # 022874
PA License # MD024845E
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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