Basic Information
| Provider Information | |||||||||
| NPI: | 1942227632 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | EVANGELICAL MEDICAL SERVICES | ||||||||
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| OtherOrganizationName: | URGENT CARE OF EVANGELICAL | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 HOSPITAL DR | ||||||||
| Address2: | SUITE 306 | ||||||||
| City: | LEWISBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 178379350 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5705224110 | ||||||||
| FaxNumber: | 5707683911 | ||||||||
| Practice Location | |||||||||
| Address1: | 7095 WESTBRANCH HWY | ||||||||
| Address2: | SUITE 1000 | ||||||||
| City: | LEWISBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 178376864 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5705233006 | ||||||||
| FaxNumber: | 5705230404 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/17/2006 | ||||||||
| LastUpdateDate: | 09/26/2018 | ||||||||
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| AuthorizedOfficialLastName: | AUCKER | ||||||||
| AuthorizedOfficialFirstName: | KENDRA | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT/CEO | ||||||||
| AuthorizedOfficialTelephone: | 5705222501 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | PA | N | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine | 261QU0200X | PA | Y | Ambulatory Health Care Facilities | Clinic/Center | Urgent Care |
No ID Information.