Provider Demographics
NPI:1235678939
Name:MILTON S HERSHEY MEDICAL CENTER PHYSICIANS GROUP
Entity Type:Organization
Organization Name:MILTON S HERSHEY MEDICAL CENTER PHYSICIANS GROUP
Other - Org Name:PENN STATE HERSHEY MEDICAL GROUP PHYSICIANS GROUP
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:MASSINI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-531-8405
Mailing Address - Street 1:PO BOX 858
Mailing Address - Street 2:
Mailing Address - City:HERSHEY
Mailing Address - State:PA
Mailing Address - Zip Code:17033-0858
Mailing Address - Country:US
Mailing Address - Phone:717-531-8521
Mailing Address - Fax:717-531-7269
Practice Address - Street 1:140 OLD WILLOW MILL RD
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050-1816
Practice Address - Country:US
Practice Address - Phone:717-766-4635
Practice Address - Fax:717-766-4818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-15
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty