1124350897 NPI number — HERSHEYCARE INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124350897 NPI number — HERSHEYCARE INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HERSHEYCARE INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
HERSHEYCARE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1124350897
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/27/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
501 W GOVERNOR RD STE 200
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HERSHEY
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17033-2219
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-534-1450
Provider Business Mailing Address Fax Number:
717-534-1707

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
501 W GOVERNOR RD STE 200
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HERSHEY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17033-2219
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-534-1450
Provider Business Practice Location Address Fax Number:
717-534-1707
Provider Enumeration Date:
02/05/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
KRAY
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
717-534-1300

Provider Taxonomy Codes

  • Taxonomy code: 333600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0004X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336L0003X , with the licence number: PP482061 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1028281880001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2126638 . This is a "PK" identifier . This identifiers is of the category "OTHER".