1568876092 NPI number — PHYSICIANS' ALLIANCE LTD

Table of content: (NPI 1568876092)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568876092 NPI number — PHYSICIANS' ALLIANCE LTD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PHYSICIANS' ALLIANCE 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:
LANCASTER HEMATOLOGY ONCOLOGY CARE
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:
1568876092
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/12/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1600 CLOISTER DR
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:
17601-2390
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-391-7092
Provider Business Mailing Address Fax Number:
717-735-2069

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
233 COLLEGE AVE
Provider Second Line Business Practice Location Address:
SUITE 303
Provider Business Practice Location Address City Name:
LANCASTER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17603-3372
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-735-3738
Provider Business Practice Location Address Fax Number:
717-735-3736
Provider Enumeration Date:
06/12/2014

Additional Information

Authorized Official

Authorized Official Last Name:
MEYERS
Authorized Official First Name:
LEE
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE VP AND COO
Authorized Official Telephone Number:
717-391-7092

Provider Taxonomy Codes

  • Taxonomy code: 207RH0003X , with the licence number:  OS012014 , 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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