1154417855 NPI number — LANCASTER GENERAL HOSPITAL

Table of content: (NPI 1154417855)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154417855 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:
WALTER L. AUMENT PSYCHOLOGY
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:
1154417855
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/02/2012
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:
Provider Business Mailing Address City Name:
LANCASTER
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17602
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-544-5511
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
317 S. CHESTNUT 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:
17566-8635
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-786-7383
Provider Business Practice Location Address Fax Number:
717-786-8635
Provider Enumeration Date:
10/04/2006

Additional Information

Authorized Official

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

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 001904610 . This is a "HIGHMARK BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 2288603000 . This is a "AMERIHEALTH 65" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 100771175 0080 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100771175 0005 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 50055738 . This is a "CAPITAL BLUE CROSS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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