1144212952 NPI number — DORIS-BILLER DORSEY, INC.

Table of content: (NPI 1144212952)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144212952 NPI number — DORIS-BILLER DORSEY, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DORIS-BILLER DORSEY, 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:
WOMEN'S HEALTH BOUTIQUE
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:
1144212952
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/04/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3018 LAKEFIELD RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
YORK
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17402-7509
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-544-3758
Provider Business Mailing Address Fax Number:
717-544-3776

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
690 GOOD DR
Provider Second Line Business Practice Location Address:
SUITE 202
Provider Business Practice Location Address City Name:
LANCASTER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17603
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-544-3758
Provider Business Practice Location Address Fax Number:
717-544-3776
Provider Enumeration Date:
08/17/2005

Additional Information

Authorized Official

Authorized Official Last Name:
DORSEY
Authorized Official First Name:
DORIS
Authorized Official Middle Name:
BILLER
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
717-544-3758

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  6000005741 , 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: 0018493500001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1512979 . This is a "GATEWAY HEALTH PLAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 122871 . This is a "HEALTH AMERICA/ASSURANCE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 132181 . This is a "THREE RIVERS HEALTH PLAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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