NPI
1711 East Broad Street Opco Llc
This page is a copy of the public NPPES file.
Facts
- Status
- Active
- Type
- Organization
- Enumeration date
- 2024-12-24
- Last updated
- 2025-03-10
Specialties
Licenses
The registry row did not include a license.
Location
- Practice location
- 1711 E Broad St
- City
- Hazleton PA
- Postal code
- 18201-5691
- Phone
- (570) 453-5100
Organization contact
- Name
- TIFFANY HOBACK
- Title
- Manager
- Phone
- 7706989040
Medicare
- PECOS
- A PECOS enrollment row matches this NPI.
LEIE
No exclusion found for this NPI in the OIG LEIE file dated October 9, 2026. OIG's online search is the official check.
Nearby
Other NPIs in Hazleton, PA. 542 records in the public file.
Removal request
Public data from NPPES and CMS. Not a credentialing determination.
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