Provider Demographics
NPI:1023003647
Name:LANCASTER GENERAL MEDICAL GROUP
Entity Type:Organization
Organization Name:LANCASTER GENERAL MEDICAL GROUP
Other - Org Name:PENN MEDICINE LGHP FAMILY MEDICINE ABBEYVILLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP FINANCIAL SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:A
Authorized Official - Last Name:KENNEDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-544-5010
Mailing Address - Street 1:101 ABBEYVILLE RD
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-4603
Mailing Address - Country:US
Mailing Address - Phone:717-291-5991
Mailing Address - Fax:717-291-5806
Practice Address - Street 1:101 ABBEYVILLE RD
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-4603
Practice Address - Country:US
Practice Address - Phone:717-291-5991
Practice Address - Fax:717-291-5806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-20
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No251B00000XAgenciesCase ManagementGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA5695OtherAETNA CAP OFFICE#
PAS1QDOtherGEISINGER HEALTH PLAN
PA515219OtherAETNA HMO
PA1007327490093Medicaid
PA874429OtherHIGHMARK BLUE SHIELD
PA5190494OtherAETNA NON-HMO
PACN7058OtherRAILROAD MEDICARE
PA02361000OtherCAPITAL BLUE CROSS
PA1518491OtherGATEWAY HEALTH PLAN
PA1007327490093Medicaid