1740319557 NPI number — MRS. ANITA JOSEFA SWISHER COTAL

Table of content: MRS. ANITA JOSEFA SWISHER COTAL (NPI 1740319557)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740319557 NPI number — MRS. ANITA JOSEFA SWISHER COTAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SWISHER
Provider First Name:
ANITA
Provider Middle Name:
JOSEFA
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
COTAL
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
JAKOB
Provider Other First Name:
ANITA
Provider Other Middle Name:
JOSEFA
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
COTAL
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1740319557
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 445
Provider Second Line Business Mailing Address:
130 CENTRAL MANOR RD
Provider Business Mailing Address City Name:
MOUNTVILLE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17554
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-285-4958
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2829 LITITZ PIKE
Provider Second Line Business Practice Location Address:
LANCASHIRE HALL
Provider Business Practice Location Address City Name:
LANCASTER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17601-3321
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-569-3211
Provider Business Practice Location Address Fax Number:
717-569-1569
Provider Enumeration Date:
03/05/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 224Z00000X , with the licence number:  OP000236L , 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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