Provider Demographics
NPI:1114340890
Name:MEDICAL WEIGHT LOSS CENTER OF HARRISBURG, LLC
Entity Type:Organization
Organization Name:MEDICAL WEIGHT LOSS CENTER OF HARRISBURG, LLC
Other - Org Name:MEDICAL WEIGHT LOSS OF PENNSYLVANIA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:KROPA
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:717-350-8810
Mailing Address - Street 1:2200 DOVER RD
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17112-1002
Mailing Address - Country:US
Mailing Address - Phone:717-695-0007
Mailing Address - Fax:717-889-0805
Practice Address - Street 1:2200 DOVER RD
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17112-1002
Practice Address - Country:US
Practice Address - Phone:717-695-0007
Practice Address - Fax:717-889-0805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-30
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083B0002XAllopathic & Osteopathic PhysiciansPreventive MedicineObesity MedicineGroup - Single Specialty
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Single Specialty