1457482341 NPI number — LANCASTER GENERAL HOSPITAL

Table of content: (NPI 1457482341)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457482341 NPI number — LANCASTER GENERAL HOSPITAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LANCASTER GENERAL HOSPITAL
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:
JAMES STREET FAMILY MEDICINE NEUROLOGY
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:
1457482341
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/13/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
555 N DUKE ST
Provider Second Line Business Mailing Address:
PO BOX 3077
Provider Business Mailing Address City Name:
LANCASTER
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17602-2250
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-544-4950
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
555 N DUKE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LANCASTER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17602-2250
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-544-4950
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/09/2007

Additional Information

Authorized Official

Authorized Official Last Name:
BYORICK
Authorized Official First Name:
FRANK
Authorized Official Middle Name:
JOSEPH
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
717-544-5511

Provider Taxonomy Codes

  • Taxonomy code: 2084N0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 100771175 0005 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000000093523 . This is a "UNISON HEALTHPLAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1016948 . This is a "MERCY" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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