Basic Information
| Provider Information | |||||||||
| NPI: | 1013674266 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | PENN STATE HEALTH LANCASTER MEDICAL CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 CRYSTAL A DR | ||||||||
| Address2: | |||||||||
| City: | HERSHEY | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170339524 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7175310003 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2160 STATE RD | ||||||||
| Address2: | |||||||||
| City: | LANCASTER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 176011812 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7175311061 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/23/2021 | ||||||||
| LastUpdateDate: | 11/23/2021 | ||||||||
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| AuthorizedOfficialLastName: | FRANKS | ||||||||
| AuthorizedOfficialFirstName: | JOE | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7175310003 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | PENN STATE HEALTH | ||||||||
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| NPICertificationDate: | 11/23/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | Y | Hospitals | General Acute Care Hospital |
No ID Information.