Provider Demographics
NPI:1154468007
Name:EPHRATA COMMUNITY HOSPITAL
Entity Type:Organization
Organization Name:EPHRATA COMMUNITY HOSPITAL
Other - Org Name:EPHRATA CANCER CENTER/ECH-MEDICAL ONCOLOGY
Other - Org Type:Other Name
Authorized Official - Title/Position:VP & PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:
Authorized Official - Last Name:CITRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-738-6407
Mailing Address - Street 1:785 5TH AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-4232
Mailing Address - Country:US
Mailing Address - Phone:717-263-9555
Mailing Address - Fax:717-709-6529
Practice Address - Street 1:460 N READING RD
Practice Address - Street 2:
Practice Address - City:EPHRATA
Practice Address - State:PA
Practice Address - Zip Code:17522-9606
Practice Address - Country:US
Practice Address - Phone:717-738-4070
Practice Address - Fax:717-738-3558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100746468Medicaid