Basic Information
| Provider Information | |||||||||
| NPI: | 1902283799 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | THE MILTON S. HERSHEY MEDICAL CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 30 HOPE DR STE 1005 | ||||||||
| Address2: | |||||||||
| City: | HERSHEY | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170332036 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7175313909 | ||||||||
| FaxNumber: | 7175310110 | ||||||||
| Practice Location | |||||||||
| Address1: | 30 HOPE DR STE 1005 | ||||||||
| Address2: | |||||||||
| City: | HERSHEY | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170332036 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7175313909 | ||||||||
| FaxNumber: | 7175310110 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/30/2015 | ||||||||
| LastUpdateDate: | 05/13/2016 | ||||||||
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| AuthorizedOfficialLastName: | ZOLKO | ||||||||
| AuthorizedOfficialFirstName: | WAYNE | ||||||||
| AuthorizedOfficialMiddleName: | W | ||||||||
| AuthorizedOfficialTitleorPosition: | SECRETARY/TREASURER | ||||||||
| AuthorizedOfficialTelephone: | 7175318084 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 3336C0003X | PP482547 | PA | Y | Suppliers | Pharmacy | Community/Retail Pharmacy |
No ID Information.