1922575539 NPI number — RESONANCE AUDIOLOGY AND HEARING AID CENTER OF LANCASTER

Table of content: (NPI 1922575539)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922575539 NPI number — RESONANCE AUDIOLOGY AND HEARING AID CENTER OF LANCASTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RESONANCE AUDIOLOGY AND HEARING AID CENTER OF LANCASTER
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:
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:
1922575539
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/01/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
406 E MAIN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW HOLLAND
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17557-1404
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-925-6112
Provider Business Mailing Address Fax Number:
717-355-2138

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
816 ESTELLE DR
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:
17601-2135
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-925-6112
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/01/2018

Additional Information

Authorized Official

Authorized Official Last Name:
HIGHFIELD
Authorized Official First Name:
JODI
Authorized Official Middle Name:
L
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
717-925-6112

Provider Taxonomy Codes

  • Taxonomy code: 231H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: AT006199 . This is a "LICENSE NUMBER" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1083843700 . This is a "NPI" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".




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