1619090107 NPI number — LANCASTER GENERAL HOSPITAL

Table of content: (NPI 1619090107)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619090107 NPI number — LANCASTER GENERAL HOSPITAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LANCASTER GENERAL 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:
MEDICAID FOR WBH
Provider Other Organization Name Type Code:
5
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:
1619090107
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/19/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 3555
Provider Second Line Business Mailing Address:
555 N. DUKE ST
Provider Business Mailing Address City Name:
LANCASTER
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17604-3555
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-544-5511
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
690 GOOD 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:
17601-2433
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-544-3700
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/09/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BYORICK
Authorized Official First Name:
FRANK
Authorized Official Middle Name:
J
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
717-544-5511

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207VM0101X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208000000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2080N0001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2080P0203X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 100771175 0078 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".