Provider Demographics
NPI:1164029658
Name:PENN STATE HEALTH HAMPDEN MEDICAL CENTER
Entity Type:Organization
Organization Name:PENN STATE HEALTH HAMPDEN MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, INTERIM
Authorized Official - Prefix:
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:SNYDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-531-0003
Mailing Address - Street 1:100 CRYSTAL A DR
Mailing Address - Street 2:
Mailing Address - City:HERSHEY
Mailing Address - State:PA
Mailing Address - Zip Code:17033-9524
Mailing Address - Country:US
Mailing Address - Phone:717-531-0003
Mailing Address - Fax:
Practice Address - Street 1:2200 GOOD HOPE ROAD
Practice Address - Street 2:
Practice Address - City:ENOLA
Practice Address - State:PA
Practice Address - Zip Code:17025-1210
Practice Address - Country:US
Practice Address - Phone:717-981-9000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PENN STATE HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-10-07
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103962850-0001Medicaid