BUCKTAIL MEDICAL CENTER


Address: 1001 Pine St, Renovo, PA 17764-1618
Phone: 5709231000

BUCKTAIL MEDICAL CENTER (NPI# 1710907043) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1710907043
Entity Type Organization
Organization Name BUCKTAIL MEDICAL CENTER
Practice Address 1001 Pine St
Renovo
PA 17764-1618
Practice Telephone 5709231000
Practice Fax Number 5709231812
Mailing Telephone 5709231000
Mailing Fax Number 5709231812
Enumeration Date 2006-07-20
Last Update Date 2016-04-26
Authorized Official Name MR. GEORGE GERBER (CONTROLLER)
Authorized Official Telephone 5705316152
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 261Q00000X Clinic/Center 549601 PA Ambulatory Health Care Facilities
Y 261QC0050X Clinic/Center
Specialization: Critical Access Hospital
549601 PA Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
PA 1007644390003 05

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1982681102 Bucktail Medical Center Medicare Defined Swing Bed Unit 1001 Pine Street, Renovo, PA 17764 2005-12-29
1821083700 Bucktail Medical Center General Acute Care Hospital 1001 Pine St, Renovo, PA 17764-1618 2005-09-15
1518944735 Bucktail Medical Center Ambulance 1001 Pine Street, Renovo, PA 17764-1618 2005-12-29
1093701047 Bucktail Medical Center Nursing Facility/Intermediate Care Facility 1001 Pine St, Renovo, PA 17764-1618 2005-09-26

Office Location

Street Address 1001 PINE ST
City RENOVO
State PA
Zip Code 17764-1618

Providers in the same location

NPI Name Taxonomy Address Enumeration
1821083700 Bucktail Medical Center General Acute Care Hospital 1001 Pine St, Renovo, PA 17764-1618 2005-09-15
1679115802 Eric Baker Physical Therapy Assistant 1001 Pine St, Renovo, PA 17764-1620 2019-10-09
1114305703 Courtney Mason Physical Therapy Assistant 1001 Pine St, Renovo, PA 17764-1618 2015-05-14
1669715660 Pa Rte 120 Inpatient Services, LLC Emergency Medicine 1001 Pine St, Renovo, PA 17764-1618 2013-03-28
1356683817 N Central Pa Emergency Physicians, LLC Emergency Medicine 1001 Pine St, Renovo, PA 17764-1618 2013-03-22
1861590523 Pattijo Edler Physician Assistant 1001 Pine St, Renovo, PA 17764-1618 2006-09-20
1003893272 Rizalito Advincula Family Medicine 1001 Pine St, Bucktail Medical Center, Renovo, PA 17764-1618 2005-12-28
1831188523 Amanda Mae Jones-sutliff Physician Assistant 1001 Pine St, Renovo, PA 17764-1618 2005-10-17
1093701047 Bucktail Medical Center Nursing Facility/Intermediate Care Facility 1001 Pine St, Renovo, PA 17764-1618 2005-09-26

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1982681102 Bucktail Medical Center Medicare Defined Swing Bed Unit 1001 Pine Street, Renovo, PA 17764 2005-12-29
1295721272 Firemens Amb Service Team Ambulance 8th and Hurron Ave, Renova, PA 17764 2005-09-23
1518170455 Western Clinton County Community Services Community/Behavioral Health 425 Saint Clair Ave, Renovo, PA 17764-1068 2007-05-07
1982837795 D&s Haulman Enterprises LLC Pharmacy 144 4th St, Renovo, PA 17764-1071 2009-08-26
1669730883 Adrienne Tripp Health Educator 208 10th St, Renovo, PA 17764-1117 2012-04-25
1497116909 Renovo Fire Department Inc Ambulance 230 11th St, Renovo, PA 17764-1121 2016-03-10
1013938059 Renovo Pharmacy Inc. Pharmacist 700 Erie Ave, Renovo, PA 17764-1130 2006-07-23
1942332705 Robert Louis Stehman Jr. Pharmacist 700 Erie Ave, Renovo, PA 17764-1130 2007-03-09
1225209646 Firemans Ambulance Service Team Ambulance 800 Huron Ave, Renovo, PA 17764-1140 2008-03-13
1649438870 Firemens Ambulance Service Team Ambulance 800 Huron Ave, Renovo, PA 17764-1140 2008-05-23
Find all providers in zip 17764

Taxonomy Information

Taxonomy Code 261QC0050X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Critical Access Hospital

Taxonomy Definition

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.
Notes: [7/1/2003: new]

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1962754895 Upmc Wellsboro Clinic/Center 32-36 Central Ave, Radiology Department, Wellsboro, PA 16901-1840 2012-10-02
1730364779 Tyrone Hospital Clinic/Center 2032 E Pleasant Valley Blvd, Altoona, PA 16602 2008-01-09
1558545376 Tyrone Hospital Clinic/Center 225 Hospital Dr, Tyrone, PA 16686-1802 2007-12-28
1861530727 Tyrone Hospital Clinic/Center 187 Hospital Dr, Tyrone, PA 16686-1808 2007-02-02

Competitor

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City RENOVO
Zip Code 17764

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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