Provider Demographics
NPI:1033256763
Name:HAMILTON HEALTH CENTER
Entity Type:Organization
Organization Name:HAMILTON HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:MS
Authorized Official - First Name:DANITA
Authorized Official - Middle Name:
Authorized Official - Last Name:HENSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-230-3906
Mailing Address - Street 1:110 SOUTH 17TH STREET
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17104-1123
Mailing Address - Country:US
Mailing Address - Phone:717-232-9971
Mailing Address - Fax:
Practice Address - Street 1:1821 FULTON ST
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17102-1522
Practice Address - Country:US
Practice Address - Phone:717-230-3906
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2017-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100748079Medicaid