1396877726 NPI number — REGIONAL GASTROENTEROLOGY ASSOCIATES OF LANCASTER, LTD

Table of content: DR. GERALD E. GARDNER D.D.S. (NPI 1891910915)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396877726 NPI number — REGIONAL GASTROENTEROLOGY ASSOCIATES OF LANCASTER, LTD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
REGIONAL GASTROENTEROLOGY ASSOCIATES OF LANCASTER, LTD
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:
Provider Other Organization Name Type Code:
6
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:
1396877726
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/15/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2104 HARRISBURG PIKE
Provider Second Line Business Mailing Address:
PO BOX 3200
Provider Business Mailing Address City Name:
LANCASTER
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17604-3200
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-544-3400
Provider Business Mailing Address Fax Number:
717-544-3408

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4140 OREGON PIKE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EPHRATA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17522
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-544-3400
Provider Business Practice Location Address Fax Number:
717-544-3408
Provider Enumeration Date:
03/12/2007

Additional Information

Authorized Official

Authorized Official Last Name:
WHITEBLOOM
Authorized Official First Name:
DALE
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
717-544-3400

Provider Taxonomy Codes

  • Taxonomy code: 261QE0800X , 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)





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