1881950483 NPI number — WELLSPAN SURGERY AND REHABILITATION HOSPITAL

Table of content: (NPI 1881950483)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881950483 NPI number — WELLSPAN SURGERY AND REHABILITATION HOSPITAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WELLSPAN SURGERY AND REHABILITATION 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:
WELLSPAN SURGERY AND REHABILITATION HOSPITAL
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:
1881950483
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/07/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
785 5TH AVE STE 3
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHAMBERSBURG
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17201-4232
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-263-9555
Provider Business Mailing Address Fax Number:
717-709-6529

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
55 MONUMENT RD
Provider Second Line Business Practice Location Address:
WELLSPAN SURGERY AND REHABILITATION HOSPITAL-PATHOLOGY
Provider Business Practice Location Address City Name:
YORK
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17403-5023
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-812-6163
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/09/2012

Additional Information

Authorized Official

Authorized Official Last Name:
BUCZKOWSKI
Authorized Official First Name:
LAURA
Authorized Official Middle Name:
Authorized Official Title or Position:
SENIOR VP AND CFO
Authorized Official Telephone Number:
410-442-3373

Provider Taxonomy Codes

  • Taxonomy code: 152WV0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 282N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1608970 . This is a "GATEWAY" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 30124632 . This is a "AMERIHEALTH MERCY - WSRH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 50117701 . This is a "CAPITAL BLUE CROSS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 50117701 . This is a "CAPITAL BLUE CROSS - WMG - WS SURG, AND REHAB HOSP-PATHOLOGY" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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