Provider Demographics
NPI:1184653792
Name:ELMWOOD CENTER MEDICAL ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:ELMWOOD CENTER MEDICAL ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CATHIE
Authorized Official - Middle Name:WEST
Authorized Official - Last Name:LENTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-755-7638
Mailing Address - Street 1:1600 6TH AVE
Mailing Address - Street 2:SUITE 114
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-2641
Mailing Address - Country:US
Mailing Address - Phone:717-755-1244
Mailing Address - Fax:717-757-7644
Practice Address - Street 1:1600 6TH AVE
Practice Address - Street 2:SUITE 114
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-2641
Practice Address - Country:US
Practice Address - Phone:717-755-1244
Practice Address - Fax:717-757-7644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA465644Medicare ID - Type Unspecified