Provider Demographics
NPI:1235460387
Name:LANCASTER GENERAL MEDICAL GROUP
Entity Type:Organization
Organization Name:LANCASTER GENERAL MEDICAL GROUP
Other - Org Name:LANCASTER GENERAL HEALTH EXPRESS - KISSEL HILL
Other - Org Type:Other Name
Authorized Official - Title/Position:SR. VP, PHYSICIAN SERVICES
Authorized Official - Prefix:DR
Authorized Official - First Name:KENT
Authorized Official - Middle Name:E
Authorized Official - Last Name:CARR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:717-544-4001
Mailing Address - Street 1:1008 LITITZ PIKE
Mailing Address - Street 2:
Mailing Address - City:LITITZ
Mailing Address - State:PA
Mailing Address - Zip Code:17543-9328
Mailing Address - Country:US
Mailing Address - Phone:717-627-6074
Mailing Address - Fax:717-627-6915
Practice Address - Street 1:1008 LITITZ PIKE
Practice Address - Street 2:
Practice Address - City:LITITZ
Practice Address - State:PA
Practice Address - Zip Code:17543-9328
Practice Address - Country:US
Practice Address - Phone:717-627-6074
Practice Address - Fax:717-627-6915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-28
Last Update Date:2010-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center