Provider Demographics
NPI:1124200787
Name:LANCASTER GENERAL HOSPITAL
Entity Type:Organization
Organization Name:LANCASTER GENERAL HOSPITAL
Other - Org Name:PENN MEDICINE LGHP HEALTHY WEIGHT MANAGEMENT & BARIATRIC SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT FINANCIAL SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:KENNEDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-544-5010
Mailing Address - Street 1:2150 HARRISBURG PIKE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-2644
Mailing Address - Country:US
Mailing Address - Phone:717-544-2935
Mailing Address - Fax:717-544-3935
Practice Address - Street 1:2150 HARRISBURG PIKE
Practice Address - Street 2:SUITE 300
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-2644
Practice Address - Country:US
Practice Address - Phone:717-544-2935
Practice Address - Fax:717-544-3935
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LANCASTER GENERAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-12-05
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RB0002XAllopathic & Osteopathic PhysiciansInternal MedicineObesity MedicineGroup - Multi-Specialty
No133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Multi-Specialty
No133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA3424568000OtherINDEPENDENCE BLUE CROSS
PA50074071OtherCAPITAL BLUE CROSS
PA9012132OtherAETNA-NON HMO
PA20071617OtherMERCY
PACK7852OtherRR MEDICARE
PA1806894OtherAETNA HMO
PA1570908OtherGATEWAY
PA000000245588OtherUNISON
PA100771175 0085Medicaid
PA2002199OtherHIGHMARK
PA2002199OtherHIGHMARK