National Provider Identifier Database

BUCKTAIL MEDICAL CENTER
Critical Access Hospital

An outpatient entity, facility, or distinct part of a facility within or affiliated with a Critical Access Hospital that provides access to primary care services for individuals in a small rural community and is Medicare certified.


Contact Information

BUCKTAIL MEDICAL CENTER
1001 PINE ST
RENOVO, PA17764-1618
Phone: 570-923-1019
Fax: 570-923-1650
Website:
Specialty Taxonomy Code
* Critical Access Hospital 261QC0050X
Clinic/Center 261Q00000X

* Indicates primary specialty

NPI Profile & details for BUCKTAIL MEDICAL CENTER

NPI Number 1710907043
Legal business name
LBN
BUCKTAIL MEDICAL CENTER
Authorized official GARY DAILEY - (ACCOUNTANT)
Entity Organization
Organization subpart No
Enumeration date 07/20/2006
Last updated 03/17/2023 - About 3 years ago
Sole proprietor1 Not specified
Identifiers
  • PA License #: 549601
  • PA Medicaid: 1007644390003

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

Reviews for BUCKTAIL MEDICAL CENTER

There are currently no reviews for BUCKTAIL MEDICAL CENTER


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