1134345911 NPI number — LEBANON COUNTY COMMISSIONERS

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 1134345911 NPI number — LEBANON COUNTY COMMISSIONERS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LEBANON COUNTY COMMISSIONERS
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:
LEBANON COUNTY MH/ID/EI PROGRAM
Provider Other Organization Name Type Code:
5
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:
1134345911
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/12/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
220 E LEHMAN ST
Provider Second Line Business Mailing Address:
MHMR GROUP
Provider Business Mailing Address City Name:
LEBANON
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17046-3930
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-274-3415
Provider Business Mailing Address Fax Number:
717-274-0317

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
220 E LEHMAN ST
Provider Second Line Business Practice Location Address:
MHMR GROUP
Provider Business Practice Location Address City Name:
LEBANON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17046
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-274-3415
Provider Business Practice Location Address Fax Number:
717-274-0317
Provider Enumeration Date:
04/18/2007

Additional Information

Authorized Official

Authorized Official Last Name:
SCHRUM
Authorized Official First Name:
KEVIN
Authorized Official Middle Name:
J.
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
717-274-3415

Provider Taxonomy Codes

  • Taxonomy code: 2084P0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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